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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 360904126
Report Date: 10/04/2022
Date Signed: 10/04/2022 12:39:12 PM

Document Has Been Signed on 10/04/2022 12:39 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:FAITH LUTHERAN DAY CARE CENTERFACILITY NUMBER:
360904126
ADMINISTRATOR:HEATHER URIBEFACILITY TYPE:
850
ADDRESS:12449 CALIFORNIA STREETTELEPHONE:
(909) 790-1816
CITY:YUCAIPASTATE: CAZIP CODE:
92399
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 25DATE:
10/04/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Director, Heather UribeTIME COMPLETED:
12:45 PM
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On 10/04/2022, Licensing Program Analyst (LPA) Destinee Hogue arrived at the facility to conduct a case management inspection regarding elevated level of lead in a classroom which was formally known as the Two Year Old Classroom. It should be noted, the Two Year Classroom is being used by the Infant Program effective, 08/15/2022. The Infant Program was also inspected on this date. During this inspection, LPA Hogue toured the facility, inside and out, took census, verified facility associations, reviewed records, and discussed the following with Director, Heather Uribe:

LPA Hogue toured the classroom, specifically the water faucet located in the classroom. LPA Hogue observed the classroom sink to have a hand washing and drinking spout, along with both spouts dispersing water.

Per Director, the facility supplies bottled water which is stored in the kitchen, and water jugs are located in each classroom. Each child has their own personalized water bottle that is located in the classroom and refilled with water from the water jug. Per Director, there is a staff member who is responsible for refilling the water jugs throughout the day. According to Director, the facility has never utilized the drinking faucets located throughout the facility, as a source of water for children. Also, Director disclosed, the sink in the classroom is not used for food preparation.

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.

Exit interview conducted and report was reviewed with the Director, Heather Uribe.

SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Destinee Hogue
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2022
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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