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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191603674
Report Date: 09/08/2022
Date Signed: 09/08/2022 03:12:40 PM


Document Has Been Signed on 09/08/2022 03:12 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245



FACILITY NAME:CALVARY CHURCH PRESCHOOLFACILITY NUMBER:
191603674
ADMINISTRATOR:ANDERS, ERINFACILITY TYPE:
850
ADDRESS:701 PALISADES DR.TELEPHONE:
(310) 573-0082
CITY:PACIFIC PALISADESSTATE: CAZIP CODE:
90272
CAPACITY:80CENSUS: 70DATE:
09/08/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Director Britney GleasonTIME COMPLETED:
01:30 PM
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On 09/08/22 at 9:10 AM, Licensing Program Analyst (LPA) Antonio Almanza, conducted an unannounced Annual Required Inspection for the preschool license. LPA met with Director Britany Gleason and toured the facility indoors and outdoors. Days and hours of operation are Monday – Friday 8:30 AM – 12:30 PM. Facility phone number is 310-573-0082. LPA conducted Risk Assessment prior to conducting site visit. During today’s visit there are 70 children and 13 Adults providing care and supervision.

Due to time constraints Annual Required Inspection was not completed and will resume at a future date. Notice of Site Visit and report were provided to the Director Britany Gleason.

SUPERVISOR'S NAME: Lisa RiosTELEPHONE: (424) 301-3072
LICENSING EVALUATOR NAME: Antonio AlmanzaTELEPHONE: (424) 301-3049
LICENSING EVALUATOR SIGNATURE:
DATE: 06/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/24/2022
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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