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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270495
Report Date: 04/25/2024
Date Signed: 04/25/2024 09:49:34 AM

Document Has Been Signed on 04/25/2024 09:49 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:BLESSED SACRAMENT CHILDREN'S LEARNING CENTERFACILITY NUMBER:
304270495
ADMINISTRATOR/
DIRECTOR:		DONALDSON, TRACIEFACILITY TYPE:
850
ADDRESS:1314 N. ANGELINA DR.TELEPHONE:
(714) 528-3070
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY: 70TOTAL ENROLLED CHILDREN: 74CENSUS: 37DATE:
04/25/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Director, Tracie DonaldsonTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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A case management inspection was conducted on this day by Licensing Program Analyst (LPA) C. Nguyen. LPA and Director toured the facility inside and outside the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 5 preschool staff and 37 preschool age children. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staffing ratios. Facility hours are 7:00a.m.- 6:00p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The purpose for today's inspection was to measure and inspect the added space yard. The following measurements were taken:

Outdoor space measurements:
84” X 90"= 7560" divided by 75"= 100 children
The following was observed:
· The yard was clear of hazardous items.
· Playground is enclosed by appropriate fence.
· Adequate shade is provided by a tree, patio, and canopy.

Based on today's measurements the facility has adequate outdoor space to serve the facility capacity of 70 children. No deficiency was observed during today's inspection. The added space yard is ready to be used by the preschool children.


Exit interview conducted and report was reviewed with the Director, Tracie Donaldson. A notice of site visit was given and must remain posted for 30 days. Appeal Rights and deficiencies were discussed. The facility representative was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Cindy Nguyen
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2024
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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