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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 330909158
Report Date: 02/03/2022
Date Signed: 02/03/2022 09:55:24 AM

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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:BUNDY CANYON CHRISTIAN SCHOOLFACILITY NUMBER:
330909158
ADMINISTRATOR:PHYLLIS WALKERFACILITY TYPE:
850
ADDRESS:23411 BUNDY CANYON ROADTELEPHONE:
(951) 674-1254
CITY:WILDOMARSTATE: CAZIP CODE:
92595
CAPACITY:60CENSUS: 43DATE:
02/03/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Phil WalkerTIME COMPLETED:
10:05 AM
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Licensing Program Analyst (LPA) Alaina Wilburn conducted an unannounced Case Management visit. LPA met with Principal Phillip Walker. The purpose of today's visit is to address an observation during a complaint visit and issue a Technical Assistance Advisory Notice.

Upon arrival to facility, LPA observed children and Principal not wearing a mask. Mr. Walker advised he thought only the Teachers and Assistants had to wear mask.

A copy of this report was provided to the Licensee on this date and must be made available to the public upon request for the next 3 years. Exit interview conducted.

A NOTICE OF SITE VISIT WAS ISSUED AND LPA VERIFIED THAT IT WAS POSTED IN A PROMINENT LOCATION AT THE FACILITY BEFORE LEAVING. THE LICENSEE UNDERSTANDS THAT IT MUST REMAIN POSTED FOR THE NEXT 30 DAYS
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
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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