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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005066
Report Date: 01/03/2022
Date Signed: 01/03/2022 11:31:59 AM

Document Has Been Signed on 01/03/2022 11:31 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ASCENSION LUTHERAN CHILDREN'S CENTERFACILITY NUMBER:
372005066
ADMINISTRATOR:LAURA VALDEZ-OROPEZAFACILITY TYPE:
850
ADDRESS:5106 ZION AVENUETELEPHONE:
(619) 582-2699
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY: 40TOTAL ENROLLED CHILDREN: 54CENSUS: 0DATE:
01/03/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Andrea LarezTIME COMPLETED:
11:40 AM
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On January 3, 2022 at 10:15 a.m. Licensing Program Analysts (LPA) Leilani Curtis conducted an unannounced case management inspection in reference to the licensee’s request for an increase in capacity and room addition. The licensee requests to increase it’s capacity from 40 children to 56 children and add room #1 to the license. The facility is currently licensed to operate in rooms #2, #3 and #4. Upon arrival LPA met with Director Andrea Larez and proceeded to tour the facility. There were no children present.

The following classroom was measured today:
Room #1 has 425.39 sq. ft. of indoor space.

The following classrooms were previously measured:
Room #2 has 307.13 sq. ft. of indoor space
Room #3 has 539.00 sq. ft. of indoor space
Room #4 has 586.35 sq. ft of indoor space

The total square footage for all classrooms is 1857.87 sq. ft. and will accommodate 53 children.

The outdoor play space was previously measured and will accommodate the requested capacity. The fire clearance for the capacity increase and room addition was granted on 12/14/21. LPA observed that all classrooms have age appropriate furnishings and equipment. Rooms were observed to be safe and free of hazards. The facility has 6 sinks, 4 toilets and 2 urinals which is enough to accommodate the requested capacity.

No deficiencies are cited.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2022
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: ASCENSION LUTHERAN CHILDREN'S CENTER
FACILITY NUMBER: 372005066
VISIT DATE: 01/03/2022
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A license with a capacity of 53 children is granted and effective today’s date, January 3, 2022. The licensed rooms are as follows: Room #1, #2, #3 and #4. An updated license will be sent for posting. An exit interview was conducted with the director and appeal rights (LIC 9058 1/16) were discussed. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed Director post notice of site visit.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2022
LIC809 (FAS) - (06/04)
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