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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191601679
Report Date: 07/02/2021
Date Signed: 07/02/2021 04:20:32 PM

Document Has Been Signed on 07/02/2021 04:20 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:CALIFORNIA HEIGHTS UNITED METHODIST NURSERY SCHOOFACILITY NUMBER:
191601679
ADMINISTRATOR:MARIA VARGASFACILITY TYPE:
850
ADDRESS:3759 ORANGE AVETELEPHONE:
(562) 595-0056
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY: 60TOTAL ENROLLED CHILDREN: 0CENSUS: 33DATE:
07/02/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:50 PM
MET WITH:April Behrendt, DirectorTIME COMPLETED:
04:41 PM
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Licensing Program Analyst (LPA) Susann conducted an announced case management- licensee initiated to review all director paperwork. Upon arrival, LPA met with Director, April Behrendt, who provided LPA a tour of the facility inside and outside. LPA reviewed all paperwork and will change name from Maria Vargas who has not worked since 01/2019 to Ms. April Behrendt. Census was taken.

Per California Code of Regulations Title 22, Division 12, no deficiency cited during today's visit. Exit interview conducted with the April Behrendt.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2021
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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