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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600117
Report Date: 11/04/2022
Date Signed: 11/04/2022 12:29:27 PM


Document Has Been Signed on 11/04/2022 12:29 PM - 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:FIRST UNITED METHODIST PRESCHOOLFACILITY NUMBER:
376600117
ADMINISTRATOR:LISA BERNADEFACILITY TYPE:
850
ADDRESS:915 PASEO RANCHEROTELEPHONE:
(619) 482-8228
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:135CENSUS: 71DATE:
11/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Lisa BernadeTIME COMPLETED:
12:30 PM
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On 11/4/22 at 11:00a.m., LPA Adrian Castellon conducted an unannounced case management inspection. LPA Castellon met with Director Lisa Bernade and discussed the purpose of the inspection.

During a file review it was determined that the facility was licensed under 915 E. H St. and Paseo Ranchero, Chula Vista, 91910. It was determined that the correct address is 1200 E. H. Street. Chula Vista 91910. LPA informed Director Lisa Bernade that the facility will need to submit the following documents with the correct address listed:
*Updated LIC 200A, LIC 308 and LIC 309. The LIC 200A and LIC 308 must be signed by one of the corporation officers currently on file with the CA Secretary of State.
*A director packet with board resolution is needed for Lisa Bernade
*Updated Staff and Parent Handbooks
*Updated Admission Agreement
*Proof of Control of Property
*A fire clearance with the corrected address
All documents are due to the San Diego Child Care Regional Office by November 18, 2022.

No Citations were issued.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:
DATE: 11/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/04/2022
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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