<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701345
Report Date: 08/10/2022
Date Signed: 08/10/2022 10:28:56 AM


Document Has Been Signed on 08/10/2022 10:28 AM - 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:COASTAL CHRISTIAN ACADEMYFACILITY NUMBER:
376701345
ADMINISTRATOR:KAREN CAMPBELLFACILITY TYPE:
850
ADDRESS:4633 DOLIVA DRIVETELEPHONE:
(858) 598-6846
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY:26CENSUS: 10DATE:
08/10/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Karen CampbellTIME COMPLETED:
10:35 AM
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
On August 10, 2022 at 8:50 a.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection in reference to the licensee’s request for a capacity increase. Upon arrival LPA met with Director Karen Campbell and proceeded to tour the facility. There were 10 children with 2 staff members present. Appropriate ratios were observed. Staff members have the required background clearances.

The facility is currently licensed for a capacity of 26 children. The Licensee requests to increase capacity to 41 children ages 2-5 years old in rooms B102, B103, B104 and B106. The following classroom was previously measured as follows:

Room B106: 256.95 sq. ft. of indoor space.

During today’s inspection LPA measured the following classrooms:

Room B102: 351.45 sq. ft. of indoor space.
Room B103: 350.25 sq. ft. of indoor space.
Room B104: 346.76 sq. ft. of indoor space.

The director requested that LPA re-measure rooms B103 and B104 because cabinets which were attached to the walls lengthwise at the initial licensing have been removed. The total preschool indoor space (rooms B102, B103, B104 and B106) is 1305.41 sq. ft. and will accommodate 37 children. LPA observed a total of 3 sinks and 3 toilets available for the children to use. The outdoor play area was previously measured and is 1976.13 sq. ft., large enough to accommodate 26 children. A fire clearance for a capacity of 41 children was granted on 7/17/22.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


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: COASTAL CHRISTIAN ACADEMY
FACILITY NUMBER: 376701345
VISIT DATE: 08/10/2022
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
26
27
28
29
30
31
32
No deficiencies are cited.

Prior to licensure, the licensee will submit a waiver request to allow 37 children to use the outdoor play area on a scheduled basis. Once the waiver request has been reviewed and approved a license for a capacity of 37 children will be sent for posting.

An exit interview was conducted with the director and appeal rights (LIC 9058 1/16) were discussed. A copy of this report as well as a copy of the appeal rights were given to the director at the conclusion of the inspection. The director’s signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the director post notice of site visit.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Grace CurtisTELEPHONE: (619) 767-2235
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2