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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304270495
Report Date: 11/21/2022
Date Signed: 11/21/2022 10:44:26 AM

Document Has Been Signed on 11/21/2022 10:44 AM - 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:BLESSED SACRAMENT CHILDREN'S LEARNING CENTERFACILITY NUMBER:
304270495
ADMINISTRATOR:DONALDSON, TRACIEFACILITY TYPE:
850
ADDRESS:1314 N. ANGELINA DR.TELEPHONE:
(714) 528-3070
CITY:PLACENTIASTATE: CAZIP CODE:
92870
CAPACITY: 70TOTAL ENROLLED CHILDREN: 70CENSUS: 40DATE:
11/21/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Tracie Donaldson, DirectorTIME COMPLETED:
10:30 AM
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Licensing Program Analysts (LPA) Valencia and Lucero conducted an on site inspection for the purpose of a Case Management Inspection. LPAs and the facility representative toured the facility inside and outside, and the floor and yard plan (LIC 999) were verified. Census was taken in individual classrooms. The overall census observed was 40 children and 7 staff. During the inspection it was determined the facility is operating within its licensed capacity and within compliance of staff to child ratios. Facility hours are 7a.m.- 6p.m., Monday through Friday. A review of the Facility Personnel Report Summary on this date indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Facility was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The facility has requested to change two of the six preschool rooms to two new portable rooms. The two rooms being removed are in the Perish Hall section of the church. The two new rooms, #5 and #6 have Sq Ft of 487 and 490, respectively. The two old rooms being removed measure 483 sq ft and 413 sq ft, respectively. An STD850 form was received from City of Placentia on 11/14/22 approving the room change. Two new portable rooms have 2 sinks and 2 toilets available for use by the preschool children. It was observed that the classrooms are safe, and in good repair and have sufficient age appropriate toys available for the children. An outdoor space of the existing preschool play yard is having a section of 703 sq ft removed. A new space of 1085 sq ft is being added to the outdoor play space capacity. This new space is fully fenced, safe, and compliant. Overall, the facility rooms and outdoor play space are safe, compliant and can accommodate the existing capacity of 70. 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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Dean Valencia
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2022
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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