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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300600313
Report Date: 06/12/2019
Date Signed: 06/12/2019 12:43:47 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: 57DATE:
06/12/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Director Amy HallTIME COMPLETED:
01:15 PM
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A case management inspection conducted on this day by Licensing Program Analyst ( LPA) Ho. Census were taken as follow: 57 preschool age children with 12 staff members. Director rearranged room 21 and requested LPA Ho to measure room 21 again. 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 21: 26'6 x 19'9 = 523'/35' = 15 children.

The following classrooms were previously measured on 5/22/19 by LPA Ho:
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.

Sink: 9 x 15 = 135 children
Toilet: 11 x 15 = 165 children.

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 has sufficient activities space to serve only 68 preschool children and 12 toddler option children.

Exit interview conducted. Notice of Site Visit was posted. Director 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: 06/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2019
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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