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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813646
Report Date: 05/30/2019
Date Signed: 05/30/2019 02:24:13 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550
FACILITY NAME:VALLEY COMMUNITY CHAPEL SCHOOL AND DAYCAREFACILITY NUMBER:
364813646
ADMINISTRATOR:LISA BALDWINFACILITY TYPE:
850
ADDRESS:59025 YUCCA TRAILTELEPHONE:
(760) 365-9049
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:65CENSUS: 37DATE:
05/30/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Lisa Baldwin TIME COMPLETED:
02:24 PM
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Licensing Program Analyst, Victoria Hunt conduct an unannounced case management visit for the purpose of decreasing the capacity for the preschool program and to also change the rooms in which the preschool program will operate. During today’s inspection, LPA Hunt met with director, Lisa Baldwin. This facility is requesting a decrease of capacity of 65 ambulatory children to 60 ambulatory children, for the preschool program license# 364813646. Facility has provided an updated facility sketch with the new proposed changes.

This facility operates year around, Monday through Friday, 6:00 AM to 6:00 PM. The preschool program will no longer operate in classroom B5. The following classrooms will be used for the preschool program: B1, B2, B3, and C1.

Bathrooms: There are a total of 4 sinks 4 toilets and 1 urinal in which the children will used. The bathrooms are located in rooms B2 and C1. Staff isolation bathrooms are located near the office.

The preschool playground will be change from the small court yard to the hard surface playground area. Measurements: 162.6 x 73.7 = 11983.62 divided by 75 = can accommodate 159 preschool children.

Exit interview conducted with the Site Supervisor, Lisa Baldwin. A Notice of Site Visit was posted on parent board and should remain for 30 days.
SUPERVISOR'S NAME: Mariela RamonTELEPHONE: (661) 789-6952
LICENSING EVALUATOR NAME: Victoria HuntTELEPHONE: (661) 568-8930
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
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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