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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191602186
Report Date: 07/17/2024
Date Signed: 07/17/2024 04:11:01 PM

Document Has Been Signed on 07/17/2024 04:11 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:MALIBU METHODIST CHURCH NURSERY CENTERFACILITY NUMBER:
191602186
ADMINISTRATOR/
DIRECTOR:		KIRSTEN BOWMANFACILITY TYPE:
830
ADDRESS:30128 MORNINGVIEW DR.TELEPHONE:
(310) 457-5144
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
07/17/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:10 PM
MET WITH:Kirsten Bowman, DirectorTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
NARRATIVE
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On July 17, 2024, at 4:10PM, Licensing Program Analyst (LPA) Dayna Chambers, conducted an unannounced case management visit for the purpose of ensuring the facility is maintaining compliance in the areas previously cited on -6/23/2022. Upon Arrival, LPA met with Director Kirsten Bowman. There were no children in care at this time.
LPA toured the facility with Director, Kirsten Bowman. This is an infant center with one classroom.

Inspection was conducted on 06/23/2022. LPA cleared deficiencies cited for:
101427(j)
101218.1(c)
1596.7995(a)(1)
101429(a)(1)
101429(a)(2)(B)(3)(a


Exit interview was conducted with Director Kirsten Bowman. 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: Valarie Cook
LICENSING EVALUATOR NAME: Dayna Chambers
LICENSING EVALUATOR SIGNATURE: DATE: 07/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/17/2024
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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