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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372006237
Report Date: 01/12/2023
Date Signed: 01/12/2023 11:10:59 AM

Document Has Been Signed on 01/12/2023 11:10 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GRACE LUTHERAN PRESCHOOLFACILITY NUMBER:
372006237
ADMINISTRATOR:BRE MANATAFACILITY TYPE:
850
ADDRESS:643 W. 13TH AVETELEPHONE:
(760) 747-3029
CITY:ESCONDIDOSTATE: CAZIP CODE:
92025
CAPACITY: 155TOTAL ENROLLED CHILDREN: 73CENSUS: 43DATE:
01/12/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Darlene Beebe, DirectorTIME COMPLETED:
11:20 AM
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On January 12, 2023 at 10: 50 AM, Licensing Program Analyst (LPA) CIndy Hamilton made an unannounced Case Management visit at Grace Lutheran Preschool to deliver an amended LIC 9099-D for a Case management visit conducted on 07/08/22 due to a deficiency amendment from Type A to Type B. LPA met with Director Darlene Beebe . Facility was toured and census conducted.

An exit interview was conducted, and a copy of this report and amended LIC 9099-D was provided to the Director. A notice of site visit was also provided and Director reminded notice must be posted for 30 consecutive days.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Cindy Hamilton
LICENSING EVALUATOR SIGNATURE: DATE: 01/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/12/2023
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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