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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701250
Report Date: 06/11/2025
Date Signed: 06/11/2025 04:51:17 PM

Document Has Been Signed on 06/11/2025 04:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FAITH CHAPEL LEARNING ACADEMYFACILITY NUMBER:
376701250
ADMINISTRATOR/
DIRECTOR:		NICOLE LAWHORNFACILITY TYPE:
850
ADDRESS:9400 CAMPO ROADTELEPHONE:
(619) 567-7557
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 93TOTAL ENROLLED CHILDREN: 93CENSUS: 32DATE:
06/11/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:25 PM
MET WITH:Paige BrakebillTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On 6/11/2025, at 2:25pm, Licensing Program Analyst (LPA) Vicky Williamson conducted an unannounced case management inspection. LPA met with Teacher Paige Brakebill and disclosed the purpose of the inspection. LPA accompanied by Teacher Paige Brakebill toured the facility. There were five staff (5) and 32 children present during the time of inspection.

On 5/30/2025, Teacher Paige Brakebill self- reported a personal rights violation involving Staff #1 (S1) inappropriately handling Child #1 (C1) and verbally inappropriately speaking to daycare children inside of the classroom. Per Teacher Paige Brakebill, the incident occurred on 5/27/2025, between 10:00am and 11:00am and there were approximately 12 children present in the classroom with S1 and Staff #2 (S2) during the time of the incident.

Teacher Paige Brakebill stated that the incident was captured through video footage. Per Teacher Paige Brakebill, C1's authorized representative was contacted immediately; and authorized representatives for all daycare children were notified via the Brightwheel App. Teacher Paige Brakebill stated that S1 was immediately terminated. Teacher Paige Brakebill stated that Facility Representative, Nicole Lawhorn will conduct a staff training regarding personal rights.

Interviews were conducted with C1, authorized representative for C1 and staff members. S1 denied the allegation. Staff files were also reviewed and copies of pertinent documentation were obtained. A review of staff files verified that S1 and S2 are aides and do not meet the qualification of a teacher.

See LIC 809C Continuation...
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Vicky Williamson
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: FAITH CHAPEL LEARNING ACADEMY
FACILITY NUMBER: 376701250
VISIT DATE: 06/11/2025
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LPA's review of video footage determined that on 5/27/2025 at 10:55am, S1 inappropriately slapped C1 on the forehead multiple times while C1 was sitting at a table inside of the classroom. LPA observed through video footage 10 additional children sitting at the same table with C1 and S2 was present and assisting another child. Per staff members and C1's authorized representative, C1 did not sustained any injuries.

Based on interviews conducted, review of video footage and review of staff qualifications, it has been determined that S1 violated the personal rights of C1, in addition S1 and S2 do not meet the qualifications of a teacher.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, the following deficiency are being cited on the attached LIC809D.

A Notice of Site Visit (LIC 9213) was given to Teacher, Paige Brakebill and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. LPA observed LIC 9213 was posted. Appeal Rights (LIC 9058) was provided. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Teacher, Paige Brakebill.
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Vicky Williamson
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/11/2025 04:51 PM - It Cannot Be Edited


Created By: Vicky Williamson On 06/11/2025 at 03:45 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: FAITH CHAPEL LEARNING ACADEMY
FACILITY NUMBER: 376701250

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/26/2025
Section Cited
CCR
101223(a)(3)

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(a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain... or other actions of a punitive nature...

This requirement is not met as evidenced by:
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Teacher Paige Brakebill stated that she will ensure that Facility Representative, Nicole Lawhorn conducts a training for staff regarding the Personal Rights of children and submit a summary of the training, a written plan detailing





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Based on observation, interview and record review, the licensee did not comply with the section cited above in that S1 violated the personal righs of C1 which poses a potential health, safety or personal rights risk to persons in care.
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how she will ensure that the personal rights of children are never violated, and include staff sign in sheet to the SDRO, no later than 6/26/2025.





Type B
06/26/2025
Section Cited
CCR101216.2(e)

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Teacher Aide Qualifications and Duties (e) An aide shall work only under the direct supervision of a teacher.

This requirement is not met as evidenced by:
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Teacher Paige Brakebill stated that she will ensure that Facility Representative, Nicole Lawhorn submits a written detailed plan stating how she will ensure that staff are qualified teachers prior to being left alone with children and submit documentation to the SDRO, no later than 6/26/2025.
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Based on interview and record review, the licensee did not comply with the section cited above in that S1 & S2 do not meet the qualifications of a teacher and were left alone in the a classroom with 11 children which poses a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Tulam Vu
NAME OF LICENSING PROGRAM MANAGER:
Vicky Williamson
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/11/2025


LIC809 (FAS) - (06/04)
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