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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 300606476
Report Date: 02/24/2025
Date Signed: 02/24/2025 12:07:37 PM

Document Has Been Signed on 02/24/2025 12:07 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GRACE HARBOR CHURCH AND SCHOOLFACILITY NUMBER:
300606476
ADMINISTRATOR/
DIRECTOR:		REBEKAH BAYFACILITY TYPE:
830
ADDRESS:12881 NEWPORT AVENUETELEPHONE:
(714) 544-4431
CITY:TUSTINSTATE: CAZIP CODE:
92780
CAPACITY: 16TOTAL ENROLLED CHILDREN: 16CENSUS: 14DATE:
02/24/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:00 PM
MET WITH:Church Office Administrator Rosani Barbosa-WelchTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
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On 2/24/25, a case management inspection was conducted by Licensing Program Analyst (LPA) Chan who met with Church Office Administrator Rosani Barbosa-Welch. The purpose of the inspection is to amend a report dated 2/19/25. Upon arrival there were 4 staff present and 14 infant children in care.

No deficiencies cited during this visit.



Exit interview was conducted with Church Office Administrator Rosani Barboza. The Notice of Site Visit was posted. Rosani Barbosa-Welch was informed that the Notice of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100. Appeal Rights was explained. A copy of appeal rights (LIC 9058 1/16) was provided and their signatures on this form acknowledge receipt of these rights. The first level appeal is to Regional Manager, address is above on the report.
SUPERVISORS NAME: Martha Malane
LICENSING EVALUATOR NAME: Anna Francesca Chan
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2025
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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