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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421700134
Report Date: 07/12/2024
Date Signed: 07/12/2024 03:48:08 PM

Document Has Been Signed on 07/12/2024 03:48 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GRACE LUTHERAN PRESCHOOLFACILITY NUMBER:
421700134
ADMINISTRATOR/
DIRECTOR:		KATHY LYNN LEDOUXFACILITY TYPE:
850
ADDRESS:420 EAST FESLERTELEPHONE:
(805) 922-5419
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 63TOTAL ENROLLED CHILDREN: 63CENSUS: 0DATE:
07/12/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:45 PM
MET WITH:TIME VISIT/
INSPECTION COMPLETED:
04:00 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
On 7/12/24, Licensing Program Analyst (LPA) Elvin Baddley attempted to conducted an unannounced Case Management Legal/Non-compliance visit/ inspection of the abovementioned Child Care Center (CCC). LPA note the facility is on the grounds of Grace Lutheran Church in Santa Maria, CA. Additionally, the CCC ceased child care services on 4/12/24, effectively closing the CCC. The purpose of the visit/inspection was to deliver Decision and Order CDSS No. 64240221018, with regard to Crystal Maria Corkern, a staff member of the former CCC.

Upon arrival of the facility, LPA went to Grace Lutheran Church's office. The door to the church office was closed. LPA contacted the facility number of record. The facility number of record went to a voice message system. LPA Baddley left a voicemail message on the system requesting a return call.

LPA left copy of aforementioned Decision and Order at office door in envelope, along with a copy of Appeal Rights (LIC 9058). The envelope was photoed. In addition to leaving this report, the report will be mailed to the facility address. .
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2024
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 1