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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701135
Report Date: 12/03/2021
Date Signed: 12/03/2021 10:38:10 AM

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:CORONADO BAPTIST INFANT CAREFACILITY NUMBER:
376701135
ADMINISTRATOR:PRYSOCK, MARTHAFACILITY TYPE:
830
ADDRESS:111 ORANGE AVENUETELEPHONE:
(619) 435-8121
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY:24CENSUS: 19DATE:
12/03/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Martha Prysock, DirectorTIME COMPLETED:
09:45 AM
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On 12/03/2021 at 9:30 a.m., Licensing Program Analyst (LPA), Michelle Hood arrived to conduct an unannounced Plan of Correction (POC) for deficiency cited on 11/18/2021. Upon arrival, LPA met with director and toured the facility. There were seven infants with two staff in classroom #1. There were 12 infants with three staff in classroom #2 at the time of inspection.

On this date, LPA reviewed 18 completed Acknowledgment of Receipt of Licensing Reports - LIC 9224 forms.

The director was provided appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. LPA provided the Notice of Site Visit - LIC 9213 and observed the LIC 9213 was posted. No deficiencies cited. An exit interview was conducted with Director Martha Prysock.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2021
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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