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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360908889
Report Date: 08/09/2022
Date Signed: 08/09/2022 11:16:11 AM


Document Has Been Signed on 08/09/2022 11:16 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501



FACILITY NAME:FAITH LUTHERAN DAY CARE CENTERFACILITY NUMBER:
360908889
ADMINISTRATOR:HEATHER URIBEFACILITY TYPE:
830
ADDRESS:12449 CALIFORNIA STREETTELEPHONE:
(909) 790-1816
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY:7CENSUS: 3DATE:
08/09/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
07:39 AM
MET WITH:Heather UribeTIME COMPLETED:
11:35 AM
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Licensing Program Analyst (LPA), Samuel Lopez arrived at the facility to conduct a Case Management inspection due to the request submitted for an increase in capacity. The facility is requesting to increase the Infant Program capacity from 7 to 10. A Fire Clearance was granted on 6/28/2022 however, documentation was not received by the Riverside Child Care Regional office until 8/1/2022.

The days and hours of operation will be Monday through Friday; 7:00 am to 5:30pm.

LPA Lopez toured the facility and measured the rooms that are assigned to the Infant Program. Based on the measurements taken, the following was determined:

Infant Indoor Activity Areas


The rooms to be utilized could not be measured due to issue surrounding the crib area. LPA will have to return at a later date to measure

Infant Bathroom Fixtures
1 toilets x 15 = 15 children
3 sinks x 15 = 45 children

Infant Outdoor Activity Area:
LPA has determined that there is sufficient outdoor activity space to accommodate 13 children.
*Waiver on file to share playground with young 2 year olds*

LPA discussed AB 2370 and provided a copy of PIN 21-21-CCP which explains the requirement for lead testing of water. All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead. Also, for a license issued on or after July 1, 2022, initial testing results shall be received and posted by January 1, 2023.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: FAITH LUTHERAN DAY CARE CENTER
FACILITY NUMBER: 360908889
VISIT DATE: 08/09/2022
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- Director Heather Uribe was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Director Heather Uribe and discussed the Child Care Licensing Safe Sleep webpage at:https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed Director Heather Uribe of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

- To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

- To access on-line Licensing forms & Regulations for a Child Care Center please visit: www.ccld.ca.gov.

- The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at:


1-844-LET-US-NO (1-844-538-8766) and/or 951-782-4200

No citations issued during today's inspection however, the separation of the crib space was discussed and Director Heather Uribe was advised.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: FAITH LUTHERAN DAY CARE CENTER
FACILITY NUMBER: 360908889
VISIT DATE: 08/09/2022
NARRATIVE
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Prior to approval of the increase in capacity the following will need to be submitted/completed and approved:
1. Barrier/walls separating the crib area needs to be installed
2. Rooms measured for sufficient square footage
3. Waiver for napping

Exit interview conducted and report was reviewed with the Director Heather Uribe.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Samuel LopezTELEPHONE: (951) 897-2482
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3