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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 503810292
Report Date: 07/09/2025
Date Signed: 07/09/2025 11:18:43 AM

Document Has Been Signed on 07/09/2025 11:18 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
FRESNO CC RO, 1310 E. SHAW AVE,
FRESNO, CA 93710
FACILITY NAME:GRACE LUTHERAN CHILD CAREFACILITY NUMBER:
503810292
ADMINISTRATOR/
DIRECTOR:		CINDY STELLEFACILITY TYPE:
860
ADDRESS:617 W ORANGEBURG AVETELEPHONE:
(209) 522-6393
CITY:MODESTOSTATE: CAZIP CODE:
95350
CAPACITY: 136TOTAL ENROLLED CHILDREN: 136CENSUS: 32DATE:
07/09/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Cindy StelleTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On 07/09/2025, Licensing Program Analyst (LPA), Nancy Her conducted an announced Pre-Licensing inspection. Facility is already licensed for preschool and school-age (500305696/503808081). Upon arrival, LPA met with Director Cindy Stelle. Applicant is requesting to be licensed for 66 preschoolers ages 2 years to 6 years in classrooms 6, 8, 13, and 14; 20 infants ages 0-2 years in classrooms 22 and 23; and 42 school age children ages 6 years to 14 years in classrooms 9 and 25. Room 7 will be used between Preschool and School Age programs. A waiver to utilize room 7 as a multipurpose room for both components is on file. Hours of operation will be Monday through Friday 6:30 am to 6:00 pm. The purpose of this inspection is to get outdoor measurements for the preschool and school age outdoor play areas.

The facility currently has a fully fenced playground area for each component. Fencing is at least four feet high. The total square footage for all the outdoor activity space for the preschool is 7,904 square feet, which is sufficient to accommodate the requested capacity. The total square footage for all the outdoor activity space for the infants is 1,203 square feet, which is insufficient to accommodate the requested capacity. A waiver will be needed. And the total square footage for all the outdoor activity space for the school age program is 43,419 square feet, which is sufficient to accommodate the requested capacity. Shade is provided via canopies and trees. There are sufficient outdoor age-appropriate toys and play equipment available on the playgrounds. There is a climbing structure on the preschool playground for children ages 2 years to 5 years which is properly anchored. There is a climbing structure on the school age playground for children ages 5 years to 12 years which is properly anchored. There is adequate cushioning in fall zones of climbers provided by wood chips. LPA observed all hazardous items on the playgrounds to be inaccessible to children. Director Cindy Stelle was reminded that any changes to the facility must be reported to and approved by Community Care Licensing. LPA informed Cindy Stelle that staff are required to maintain direct visual supervision of the children at all times during indoor and outdoor activities.

A license for 66 preschoolers, 20 infants, and 42 school age children will be granted upon a final file review.Exit interview conducted and report was reviewed with the facility representative Cindy Stelle.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Nancy Her
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/09/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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