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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845899
Report Date: 04/25/2022
Date Signed: 04/25/2022 12:52:50 PM

Document Has Been Signed on 04/25/2022 12:52 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GRACE CHRISTIAN PRESCHOOLFACILITY NUMBER:
334845899
ADMINISTRATOR:BROWN, BAILEIGHFACILITY TYPE:
850
ADDRESS:2781 S LINCOLN AVETELEPHONE:
(951) 736-7466
CITY:CORONASTATE: CAZIP CODE:
92882
CAPACITY: 92TOTAL ENROLLED CHILDREN: 92CENSUS: 74DATE:
04/25/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Baileigh Brown, Director TIME COMPLETED:
01:10 PM
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Licensing Program Analysts (LPAs) Karrene Phillips and Blanca Ruiz arrived at the facility to conduct a case management visit in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was entered by the licensing agency on 03/24/2022. It indicates on 03/14/2022, Child #1 received an injury after a parent crossed paths with the child and their parent causing a collision resulting in Child #1 sustaining an injury requiring medical treatment.

Facility records were reviewed and interviews were conducted. Based on information gathered, the facility acted appropriately and no violations have been identified. Child #1's parent was on-site with the child when the incident occurred. The teachers provided an immediate response by gathering medical supplies to attend to the injury.

Exit interview was conducted with Baileigh Brown, Director. A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.



A copy of this report was provided to the facility and must be made available to the public for three years upon request.
SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Karrene Phillips
LICENSING EVALUATOR SIGNATURE: DATE: 04/25/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/25/2022
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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