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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191228582
Report Date: 03/28/2024
Date Signed: 03/28/2024 12:04:21 PM

Document Has Been Signed on 03/28/2024 12:04 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:FAITH BAPTIST SCHOOL/INFANTSFACILITY NUMBER:
191228582
ADMINISTRATOR:OROZCO, ELIZABETHFACILITY TYPE:
830
ADDRESS:7644 FARRALONE AVENUETELEPHONE:
(818) 340-6131
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY: 12TOTAL ENROLLED CHILDREN: 10CENSUS: 7DATE:
03/28/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Elizabeth Orozco, Director.TIME COMPLETED:
12:20 PM
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On 03/28/2024, Licensing Program Analyst (LPA) Silva Garibyan conducted an unannounced case management inspection for the purpose of citing deficiencies observed during a complaint investigation for Complaint Control Number 58-CC-20231130080821. LPA met with Director, Elizabeth Orozco, and explained the purpose of the visit. During today’s visit, there were three staff providing care to seven infants. During the complaint investigation it was observed that the sleeping area for infants is not physically separated from the indoor activity space. LPA Garibyan explained to the director that they may use movable walls or partitions to separate the sleeping area from the indoor activity space and that these moveable walls or partitions, if used, shall be at least four feet high; shall be constructed of sound-absorbing material; and shall be designed to minimize the risk of injury to infants. The following Type B deficiency is being cited on 03/28/2024 in accordance to Title 22 of the California Code of Regulations:

101438.3 Indoor Activity Space for Infants
(c)(1) The sleeping area for infants shall be physically separate from the indoor activity space. This separation shall be accomplished as specified in (b) above.

Exit interview conducted with and a copy of this Report (LIC809 and LIC809-D), Notice of Site Visit, and Appeal Rights (LIC 9058), was provided and explained to Elizabeth Orozco, Director.
SUPERVISORS NAME: Betty Bell
LICENSING EVALUATOR NAME: Silva Garibyan
LICENSING EVALUATOR SIGNATURE: DATE: 03/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/28/2024
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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Document Has Been Signed on 03/28/2024 12:04 PM - It Cannot Be Edited


Created By: Silva Garibyan On 03/28/2024 at 10:19 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: FAITH BAPTIST SCHOOL/INFANTS
FACILITY NUMBER: 191228582

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/11/2024
Section Cited
CCR
101438.3(c)(1)

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Indoor Activity Space for Infants:
The sleeping area for infants shall be physically separate from the indoor activity space. This separation shall be accomplished as specified in (b) above. This requirement is not met as evidenced by:
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The director will resolve the issue to ensure the separation of areas and submit photo evidence to CCL by the COB on the POC due date of 04/11/2024.
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 the sleeping area for infants is not physically separate from the indoor activity space which poses a potential Health or Safety, or personal rights risk to persons in care.

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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Betty Bell
LICENSING EVALUATOR NAME:Silva Garibyan
LICENSING EVALUATOR SIGNATURE:
DATE: 03/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/28/2024


LIC809 (FAS) - (06/04)
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