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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370800144
Report Date: 11/30/2021
Date Signed: 11/30/2021 01:52:55 PM

Document Has Been Signed on 11/30/2021 01:52 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CORONADO BAPTIST CHILD CARE CENTERFACILITY NUMBER:
370800144
ADMINISTRATOR:PRYSOCK, MARTHAFACILITY TYPE:
850
ADDRESS:111 ORANGE AVENUETELEPHONE:
(619) 435-8121
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY: 58TOTAL ENROLLED CHILDREN: 58CENSUS: 20DATE:
11/30/2021
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:John Roamer, PastorTIME COMPLETED:
02:15 PM
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On 11/30/2021 at 12:00 p.m., Licensing Program Analyst (LPA), Michelle Hood arrived to conduct an unannounced Plan of Correction (POC) for deficiencies cited on 11/10/2021 & 11/18/2021 and to deliver an amended licensing report from an original report dated 11/10/2021. Upon arrival, LPA met with staff Stephanie Vargas and toured the facility. There were 11 children outside with one staff, and two children in classroom #1 with one staff. There were seven children outside with one staff from classroom #2 at the time of inspection.

On this date, LPA observed a revised face covering letter posted throughout the facility. LPA observed 20 children not displaying a runny nose or cough. The pastor provided LPA a completed Covid-19/Ouch Report. The LIC 9224 forms were not available for review. LPA discussed and provided the Pastor a copy of the LIC 9224 form. LPA observed the Notice of Site - LIC 9213 posted from the inspection on 11/19/2021 on the wall in the lobby.

The Pastor was provided appeal rights (LIC 9058 01/16) and their signature on this form acknowledges receipt of these rights. LPA provided the Notice of Site Visit - LIC 9213 and observed the LIC 9213 was posted. No deficiencies cited. An exit interview was conducted with Pastor John Roamer.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2021
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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