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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372000473
Report Date: 07/20/2023
Date Signed: 07/20/2023 02:10:48 PM

Document Has Been Signed on 07/20/2023 02:10 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:RANCHO BERNARDO COMMUNITY CHURCH PRESBYTERIAN PREFACILITY NUMBER:
372000473
ADMINISTRATOR:KIM VANDERGRIFTFACILITY TYPE:
850
ADDRESS:17010 POMERADO ROADTELEPHONE:
(858) 487-0824
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY: 105TOTAL ENROLLED CHILDREN: 105CENSUS: 0DATE:
07/20/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Adam MartinTIME COMPLETED:
02:20 PM
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On 7/20/23 at 12:45pm Licensing Program Analysts (LPAs) Patrick Ma arrived at the facility to conduct a case management inspection to update classroom measurements for license and add Fellowship Hall. School was closed for summer break when LPA arrived. Director Kim Vandergrift was not present on site. LPA met with Facility Technician, Adam Martin. LPA introduced himself and explained purpose of visit. No children were present at the facility. LPA measured rooms 140 – 143, 150, 152 – 153, and north side of Fellowship Hall (with partition). Room 151 is Preschool and Director’s office.

Room 140: 579.62 square feet
Room 141: 592
Room 142: 577.8
Room 143: 544.5
Room 150: 731.5
Room 152: 305.5
Room 153: 570.9
Fellowship Hall: 3,380.62

The total indoor square footage calculation for the Preschool classrooms is 3841.82 square feet which is sufficient to accommodate 109 students, with the Fellowship Hall combined is 7,222.44 square feet. There is no change in current capacity which remains 105. Room allowance capacity must still be followed.
No deficiencies are cited.

Exit interview conducted and report was reviewed with the facility representative Adam Martin. A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2023
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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