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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330907905
Report Date: 07/30/2019
Date Signed: 07/30/2019 02:08:02 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:EDEN LUTHERAN SCHOOLFACILITY NUMBER:
330907905
ADMINISTRATOR:DARLENE KEANEMANFACILITY TYPE:
850
ADDRESS:4725 BROCKTON AVENUETELEPHONE:
(951) 683-7001
CITY:RIVERSIDESTATE: CAZIP CODE:
92506
CAPACITY:60CENSUS: 9DATE:
07/30/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:DARLENE KEANEMANTIME COMPLETED:
02:15 PM
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Licensing Program Analysts (LPAs) John Huynh and Samuel Lopez arrived at the facility to conduct a case management inspection due to the facility submitting an application to add the Toddler Option Program age 18 months to 36 months with a capacity of 6, to the Preschool License. LPAs toured facility and took census with the Director, Darlene Keaneman. The Preschool will operate Monday through Friday, 6:30AM to 6:00PM.

Measurements were not taken during the inspection, as there has not been any changes to the previously licensed areas. A current fire clearance is on file.

Toddler Option Classroom will operate in Class room #2, ONLY. Toddler option is equipped with appropriate equipment inside and outside at the current time.

Preschool Classroom will operate in Preschool classrooms:

Classroom 3 = Preschool
Classroom 4 = Preschool
Classroom 5 = Preschool
Classroom 6 = Preschool

There is no change in capacity of 60, ambulatory children. The request for Toddler Option will be granted. The facility will be a Preschool facility with Toddler Option.

An exit interview was conducted with Director, Darlene Keaneman and a copy of this report was provided on this date. A copy of this report must be made available to the public, at the facility site, for the next 3 years.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: John HuynhTELEPHONE: (951) 529-2439
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2019
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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