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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600313
Report Date: 05/22/2019
Date Signed: 05/22/2019 04:12:43 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:FIRST BAPTIST CHURCH VALLEY DAY PRE SCHOOLFACILITY NUMBER:
300600313
ADMINISTRATOR:HALL, AMYFACILITY TYPE:
850
ADDRESS:17415 MAGNOLIA AVENUETELEPHONE:
(714) 847-4844
CITY:FOUNTAIN VALLEYSTATE: CAZIP CODE:
92708
CAPACITY:80CENSUS: DATE:
05/22/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Office Manager Corey PeshkeTIME COMPLETED:
04:45 PM
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A case management inspection conducted on this day by Licensing Program Analyst ( LPA) Ho. Facility is requesting to add a toddler option component to the existing preschool license. Facility is currently licensed 80 preschool children only. Facility is seeking to serve 72 preschool children and 12 toddlers ages 18 to 36 months old. Rooms 10,11,12 (all in 1 big room) will be used to serve the toddler option children. Census was taken as follow: 43 preschool children with 5 staff members. A review of staff records on this date indicated that all facility staff or other individuals who required caregiver background checks have received criminal record and child abuse index clearances or exemptions.
Measurement was taken as follows:
Indoor space:
Room #10,11,12 (all in 1 big room): 28' x 15.6' = 434'
11' x 20' = 220'
Total: 434' + 220" = 654' '/35' = 18 children
Room #3,4,5,6 (have the same measurement) 20' x 17'6 = 350'/35' = 10 children for each room.
Room 20: 23' x 20 = 470'/35' = 13 children.
Room 21: 26'6 x 17'6 = 463.75'/35' = 13 children.

Sink: 9 x 15 = 135 children
Toilet: 11 x 15 = 165 children.
Toddler option children will be sharing the play yard with the preschool children using the staggered schedules. Waiver has been submitted to LPA for approval.

Fire clearance from Fountain Valley Fire Inspection Services has been received and approved for requested capacity.
Base on today’s measurements and the sink & toilet availability, center does not have sufficient
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy HoTELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2019
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: FIRST BAPTIST CHURCH VALLEY DAY PRE SCHOOL
FACILITY NUMBER: 300600313
VISIT DATE: 05/22/2019
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 activity space to support the requested capacity of 72 preschool and 12 toddler option children.

Office manager will discuss with director to change toddler option to a different room and requested LPA to return at a later day to inspect the facility.

Exit interview conducted. Notice of Site Visit was posted. Facility representative was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.
SUPERVISOR'S NAME: Rina LopezTELEPHONE: (714) 703-2808
LICENSING EVALUATOR NAME: Thuy HoTELEPHONE: (714) 703-2824
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
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