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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600983
Report Date: 09/12/2019
Date Signed: 09/12/2019 11:58:14 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:ZION LUTHERAN PRESCHOOLFACILITY NUMBER:
376600983
ADMINISTRATOR:JANEY, LANAFACILITY TYPE:
850
ADDRESS:1405 E. FALLBROOK STREETTELEPHONE:
(760) 723-3500
CITY:FALLBROOKSTATE: CAZIP CODE:
92028
CAPACITY:60CENSUS: 48DATE:
09/12/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lana JaneyTIME COMPLETED:
12:15 PM
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A case management inspection is being conducted as this facility has requested a capacity increase from 60 children to 124 children. Licensing Program Analyst (LPA), James Wilkerson, toured the center, inside and out. The facility is also being inspected for a random annual inspection.

The application is requesting a total of 124 children. The fire clearance was granted on 08/14/19 for 124 children. Measurements indicate up to 147 children could be accommodated inside and 62 outside.

This facility is located on an church elementary school site and has ample sinks and bathrooms to accommodate 124 children.

The total amount of children to be served at this facility is 124 children per the application request and the fire clearance that was granted.

An exit interview was conducted and a copy of this report was provided to Ms. Janey on this date.

A copy of this report must be made available to the public, upon request for three years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: James WilkersonTELEPHONE: (951) 218-7031
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019
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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