376701235-12-13-2019-20-CC-VWIN-BJU463-20191213174851

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376701235
Report Date: 12/13/2019
Date Signed: 12/13/2019 05:48:57 PM

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:	CONCORDIA CHURCH & SCHOOL		FACILITY NUMBER:	376701235
ADMINISTRATOR:	AARON PARTCH		FACILITY TYPE:	840
ADDRESS:	1695 DISCOVERY FALLS ROAD		TELEPHONE:	(619) 656-8100
CITY:	CHULA VISTA	STATE: CA	ZIP CODE:	91915
CAPACITY:	90	CENSUS: 20	DATE:	12/13/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	04:05 PM
MET WITH:	Aaron Partch		TIME COMPLETED:	06:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	Licensing Program Analyst (LPA) Vicky Williamson conducted an annual random inspection. LPA met with Director, Aaron Parth. This program operates Monday - Friday from 6:30 AM to 6:30 PM during summer hours. Monday - Friday from 1:30 PM - 6:30 PM while school is in session. There were 20 school age children present during the time of inspection. The school age classroom, playground and the children's restrooms were inspected. Classroom has lighting, heating, and ventilation as well as an operational carbon monoxide detector. Children are being escorted to and from the restrooms with visual observation. All floors appeared to be clean and safe. Furniture including tables, chairs and equipment appeared to be in good condition. Trash cans containing discarded food have tight-fitting covers. Disinfectants, cleaning solutions and other hazardous items were locked and inaccessible to children. Snack menu is posted weekly. The surface of the outdoor activity space is maintained in a safe condition and free of hazards. Drinking water is available inside the classrooms and on the playground. Sign in / Sign out sheets were reviewed showing staff and parent/guardian’s signature and time of day recorded. Children's records, including admission agreement and facility roster were all reviewed. Staff's records, including health screening, immunization record and transcripts were reviewed to verify teacher qualifications and experience. Opening and closing staff members have current CPR and First Aid certifications. A review of staff records on 12/13/19 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CONCORDIA CHURCH & SCHOOL	FACILITY NUMBER: 376701235
	VISIT DATE: 12/13/2019

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Facility is currently not providing IMS. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA and Director reviewed reporting requirements, sign in /sign out procedures, Provider Information Notice (PIN) and Effects of Lead Exposure.

Please update and submit forms LIC 308, LIC 610 and LIC 500 to the Licensing Agency by January 13, 2019

Southern California Child Care Advocate information was provided, and Director was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

No deficiencies cited during today's inspection. Director was provided a copy of the appeal rights form LIC 9058 and the signature on this form acknowledges receipt of these rights.

The Notice of Site Visit (LIC 9213) was provided to be posted at the facility for 30 days. LPA observed form LIC 9213 posted.

SUPERVISOR'S NAME: Joe Carrasco	TELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Vicky Williamson	TELEPHONE: (619) 767-2214
LICENSING EVALUATOR SIGNATURE:	DATE: 12/13/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2019

LIC809 (FAS) - (06/04)

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