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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304370703
Report Date: 10/26/2022
Date Signed: 10/26/2022 09:50:20 AM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 10/26/2022 09:50 AM - It Cannot Be Edited

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:ANAHEIM MAGNOLIA DAYCAREFACILITY NUMBER:
304370703
ADMINISTRATOR:MILLER, CATHYFACILITY TYPE:
840
ADDRESS:720 SOUTH MAGNOLIA AVENUETELEPHONE:
(714) 484-6654
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:90CENSUS: 0DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Chuck Nordell - Associate PastorTIME COMPLETED:
09:55 AM
NARRATIVE
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Licensing Program Analyst (LPAs) Odom and Lucero attempted to conduct a unannounced annual visit at the facility on today's date. LPAs met with Chuck Nordell, Associate Pastor who informed LPA's that they had decided to permanently close the childcare center the beginning of 2021 during the pandemic. Mr. Nordell stated they sent in a letter to licensing office the beginning of 2021 to notify licensing that they were no longer operating. Mr. Nordell provided a written letter on today's date to permanently close the childcare center effective 01/01/2021. Mr. Nordell was unable to return the childcare license due to being stored in boxes when the childcare center closed down.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 703-2807
LICENSING EVALUATOR NAME: Carmen OdomTELEPHONE: (714) 703-2819
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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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