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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300603522
Report Date: 04/13/2023
Date Signed: 04/13/2023 12:06:59 PM

Document Has Been Signed on 04/13/2023 12:06 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GRACE HARBOR CHURCH AND SCHOOLFACILITY NUMBER:
300603522
ADMINISTRATOR:REBEKAH BAYFACILITY TYPE:
850
ADDRESS:12881 NEWPORT AVENUETELEPHONE:
(714) 544-4431
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 78TOTAL ENROLLED CHILDREN: 78CENSUS: 41DATE:
04/13/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rebekah Bay - DirectorTIME COMPLETED:
10:30 AM
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On 4/13/23, a follow-up proof of correction inspection that was made by Licensing Program Analysts (LPAs) Tran and LPA Chan. LPAs met with Director Rebekah Bay, who guided the analysts on a tour of the facility. Census was taken as follows; 41 preschool children and 6 staff members. LPAs informed the Director of the purpose of today's visit.

A review of the Facility Personnel Report Summary on 04/13/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

On 3/29/23, an initial unannounced case management visit was conducted and a LIC 809 was completed. A type A deficiency was previously cited on a LIC 809D, in accordance with California Code of Regulations, Title 22, Division 12, Section 101229(a)(1) Responsibility for Providing Care and Supervision. This was a repeated violation that was previously cited on 03/09/2023. On 03/29/2023, a plan of correction was discussed with Director Rebekah Bay, in which, the Director provided a detailed plan to address the importance of providing supervision in care including supervision strategies, and ensuring all interior doors locked in sanctuary, while preschool children are on campus, and document of discussion with church administrative staff to keep door closed and locked.

On 4/6/23, a follow-up visit was made, and LPAs observed the Notice of Site Visit was posted. During the inspection, 1 door out of 3 office doors in the Sanctuary was not locked. This unlocked door is open into Room # 11, an off-limit room, and this room #11 has another exit door into the parking lot of the facility. Plan of Correction was not cleared on 4/6/23 and a civil penalty was assessed for repeated violation on 4/6/23.



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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: GRACE HARBOR CHURCH AND SCHOOL
FACILITY NUMBER: 300603522
VISIT DATE: 04/13/2023
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On 4/13/23, during today’s visit, LPAs observed the Notice of Site Visit and licensing reports were posted. Based on LPAs observation and inspection, all 3 doors (Church Office, Room #11 and Room # 11 other door) in the Sanctuary were kept locked and signs were up by the doors “Door Must Remain Locked During School Hours (Monday-Friday 7am-6pm)”. During an interview with the Director, she stated that the facility is keeping all 3 doors locked during school hours. Facility is within compliance with the Plan of Correction to keep the doors in the sanctuary always locked while preschool children are present.

In the areas that were evaluated, NO deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

An exit interview was conducted, and report was reviewed with Director Rebekah Bay. A notice of site visit was given and must remain posted for 30 days.

Appeal Rights were explained. The Director was provided a copy of appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First level appeals should be sent to the regional manager to the address listed above.

(End of Report)

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SUPERVISORS NAME: Rina Lopez
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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