191500105-5-15-2025-33-CC-CTUA-DGPUE9-20250515153046

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191500105
Report Date: 05/15/2025
Date Signed: 05/15/2025 03:30:57 PM

Document Has Been Signed on 05/15/2025 03:30 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	CALVARY BAPTIST SCHOOLS %FORMERLY BONITA CHRISTIA		FACILITY NUMBER:	191500105
ADMINISTRATOR/ DIRECTOR:	PAULA BRANDT		FACILITY TYPE:	850
ADDRESS:	2990 N DAMIEN AV		TELEPHONE:	(909) 593-4672
CITY:	LA VERNE	STATE: CA	ZIP CODE:	91750
CAPACITY: 31	TOTAL ENROLLED CHILDREN: 39	CENSUS: 26	DATE:	05/15/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:45 PM
MET WITH:	Inez Sidow		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 05/15/2025, at 12:45 PM Licensing Program Analyst (LPA) Carolyn Tuba conducted an unannounced required inspection for a preschool program. LPA entered facility through the main gate of the Calvery Baptist Schools. LPA met with the school office staff who guided the LPA to the preschool classroom. The preschool is shared with an elementary thru 12^th grade school site. LPA met with Director, Inez Sidow and LPA observed 26 children with 3 staff during nap time. According to the Director there are 39 children enrolled on various schedules. The following classrooms were inspected: preschool classroom A-1 which can become two classrooms when the double doors are closed or convert to one big classroom. All staff members were fingerprint cleared. Licensed facility is within the conditions, limitations, and capacity specified on the license. The program takes care of children ages 2 years to 5 years old. Hours of operation are 6:00 am – 6:00 pm Monday-Friday. During the visit LPA toured the inside and the outside of the preschool. The classroom furniture and equipment were inspected for good repair, free of sharp, loose, or pointed parts. Indoor classrooms were inspected to ensure that the floors have a surface that is safe and clean. Telephone service, heating, lighting, and ventilation were evaluated. Storage for children’s belongings was inspected and meet all regulatory requirements. Availability of drinking water was reviewed and per Director children bring water bottles from home and water is provided by the facility using a water station that uses a filtration device to provide water and refills to the children in care. Isolation is in the office and parents are notified to pick-up. page 1 of 4

NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

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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Document Has Been Signed on 05/15/2025 03:30 PM - It Cannot Be Edited

Created By: Carolyn Tuba On 05/15/2025 at 02:58 PM

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
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY BAPTIST SCHOOLS %FORMERLY BONITA CHRISTIA	FACILITY NUMBER: 191500105
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/15/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, the licensee did not comply with the section cited above in not testing for lead as required which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/16/2025
	Plan of Correction
1 2 3 4	Per Director and Pastor of the school lead testing will be completed and scheduled as soon as possible. LPA provided PIN 21-21.1 CCP as information needed on prodcedures for lead testing. Results will be provided to LPA.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Katrina Chicote
NAME OF LICENSING PROGRAM MANAGER:

	Carolyn Tuba
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/15/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY BAPTIST SCHOOLS %FORMERLY BONITA CHRISTIA	FACILITY NUMBER: 191500105
	VISIT DATE: 05/15/2025

NARRATIVE

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Napping sheets and blankets are provided by parents and sent home Friday to be laundered.

Facility has a total of 7 child-size toilets and 5 child-size sinks with a changing table for children who are still potty training located near a sink for hand washing. A separate staff restroom is available inside the classroom.

Toys and surfaces are observed to be safe and clean. The parents sign-in and-out sheets are located by the main entrance of the facility. Director was reminded to have parents use full signatures.

Combo carbon monoxide and smoke detectors were present in the facility and are tested annually by the Fire Department. Fire extinguishers were last serviced June 21, 2024. Storage cabinets in classrooms were inspected and no hazardous items were found, cleaning items were located out of reach and inaccessible to children in care. No poisonous cleaning compounds were found in the childcare center. Emergency disaster drill was last conducted and documented on April 2025. There is a First Aid kit available; the supplies were inventoried and found to be in good condition.

Food preparation areas were toured for safety, cleanliness, and proper equipment. Facility has a full kitchen that was inspected and is kept locked while children are in the facility. Lunch is provided by parents and AM/PM snacks are served by the facility. Menu is posted on the parent board. LPA observed parent board with all required documentation located in the facility as well as a daily schedule.

LPA was informed that there are currently no children on medication, but IMS was discussed. Should medication be needed then it is kept in the kitchen locked up.

Outdoor playground equipment is in safe condition, free of sharp, loose, or pointed parts. The surface of the outdoor activity space is maintained in a safe condition and is free of hazards. There is currently one playground with play equipment and is surrounded by a chain link fence. All areas around or under climbing equipment, slides, and similar equipment are cushioned with wood chips. There is adequate shade in the play yard with an awning and there were plenty of bikes and playhouses, as well as a sand box. LPA advised that the sand and wood chips should be raked and inspected. Director stated that the staff do that daily and that wood chips are refilled once a year. Play area was inspected for hazards. According to Director there are no bodies of water; and no bodies of water or hazards were observed.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY BAPTIST SCHOOLS %FORMERLY BONITA CHRISTIA	FACILITY NUMBER: 191500105
	VISIT DATE: 05/15/2025

NARRATIVE

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LPA reviewed staff records and found that they were complete. Mandated Reporter Training, and Pediatric CPR/1^st Aid, was EMSA approved were found to be current. Clearance for adults, educational requirements, immunization records and health preventative practices documentation was reviewed and found to be complete.

Children’s records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file and were complete.

The facility does not provide any transportation to the children in care.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a childcare facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers. LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

LIC809 (FAS) - (06/04)

Page: 5 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: CALVARY BAPTIST SCHOOLS %FORMERLY BONITA CHRISTIA	FACILITY NUMBER: 191500105
	VISIT DATE: 05/15/2025

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE, LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

The following deficiency listed on the attached LIC 9099-D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiency that are being cited need to be cleared to protect the children’s health & safety.

LPA, Carolyn Tuba informed Director, Inez Sidow that this report dated 5/15/2025 document(s) (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety or personal rights of a children in care. Also, LPA, Carolyn Tuba informed Director, to provide a copy of this licensing report dated 5/15/2025 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC9224), or written statement, must be placed in the child’s file for verification.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Inez Sidow.
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NAME OF LICENSING PROGRAM MANAGER: Katrina Chicote
NAME OF LICENSING PROGRAM ANALYST: Carolyn Tuba
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/15/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2025

LIC809 (FAS) - (06/04)

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