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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198014862
Report Date: 03/18/2022
Date Signed: 03/18/2022 01:17:22 PM

Document Has Been Signed on 03/18/2022 01:17 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CALVARY CHAPEL CHRISTIAN PRESCHOOLFACILITY NUMBER:
198014862
ADMINISTRATOR:BLANCA SANCHEZFACILITY TYPE:
850
ADDRESS:12808 WOODRUFF AVENUETELEPHONE:
(562) 299-9100
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY: 95TOTAL ENROLLED CHILDREN: 95CENSUS: 73DATE:
03/18/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Christy Leonard & Denisse CardenasTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Elka Chavez conducted a case management inspection to the above named facility. LPA met with Facility Representative, Christy Leonard who assisted LPA with touring the facility. Also, present was Facility Representative, Denisse Cardenas.

At 10:10 AM LPA toured the facility. Based on records and interviews it was determined that Christy Leonard is currently the Assistant Principal for Calvary Chapel Elementary School and is still in the process of becoming the director for the preschool. Based on interviews and review of Guardian Background Check System, Christy Leonard does not have finger print clearance. This poses an immediate risk to the health and safety of children in care.

A notice of site visit was given and must remain posted for 30 days.



Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Elka Chavez informed facility representative, Denisse Cardenas that this report dated 3/18/22 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Elka Chavez informed the facility representative, Denisse Cardenas to provide a copy of this licensing report dated 3/18/22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview was conducted with Facility Representative, Denisse Cardenas. Facility Representative Christy Leonard stepped away to run an errand.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Elka Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 03/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2022
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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Document Has Been Signed on 03/18/2022 01:17 PM - It Cannot Be Edited


Created By: Elka Chavez On 03/18/2022 at 11:43 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/18/2022
Section Cited
CCR
101170(e)(1)

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101170(e) (1): Criminal Record Clearance--All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: Obtain a California clearance or a criminal record etc... This requirement was not met as evidenced by...
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Will inform upper administarion of the title 22 regulation requirement for preschool staff, volunteers must have fingerprint clearance prior to working or volunteering in the facility.
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Based on interviews and review of Guardian Background Check System, Christy Leonard does not have finger print clearance. This poses an immediate health and safety risk to the children in care. $500 Civil Penalty was accessed.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Elka Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/18/2022 01:17 PM - It Cannot Be Edited


Created By: Elka Chavez On 03/18/2022 at 11:49 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY CHAPEL CHRISTIAN PRESCHOOL
FACILITY NUMBER: 198014862

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/29/2022
Section Cited
CCR
101215.1(b)

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101215.1 Child Care Center Directors Qualifications and Duties (b) All child care centers shall have a director.This requirement was not met as evidenced by...
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Preschool will inform the upper administration of the title 22 regulation requirement for a preschool director. Corerctions will be provided to LPA by POD due date.
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 Based on records and interviews it was determined that Christy Leonard is currently the Assistant Principal for Calvary Chapel Elementary School and is still in the process of becoming the Preschool director.This poses a potential health and safety risk to children in care.potential
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Karen Chambers
LICENSING EVALUATOR NAME:Elka Chavez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2022


LIC809 (FAS) - (06/04)
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