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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191671293
Report Date: 08/27/2021
Date Signed: 08/27/2021 04:08:54 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ST. LUKE'S PRESCHOOLFACILITY NUMBER:
191671293
ADMINISTRATOR:CANDICE PEARSONFACILITY TYPE:
850
ADDRESS:5633 E. WARDLOW ROADTELEPHONE:
(562) 420-7308
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:61CENSUS: 0DATE:
08/27/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Candice PearsonTIME COMPLETED:
04:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Warren Birks conducted a Case Management Inspection. LPA met with Director Candice Pearson who assisted with the visit. The purpose of this visit is to conduct technical assistance using the Covid-19 Self Assessment Guide and observe clearance documentation.

LPA discussed the Covid-19 Self Assessment Guide. LPA also provided the facility with Los Angeles County Child Care Guidance regarding Covid-9 (updated June 21, 2021). There were no children as this day was a faculty work day to prepare for the next session August 30, 2021.

Director Pearson submitted a staff roster and information regarding staff fingerprint clearance and association. The facility was also conducting a Parent orientation at the time of the visit. LPA to conduct a required visit at a later date. There were no Title 22 violations recorded during this visit.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with Director Pearson.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021
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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