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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701490
Report Date: 09/28/2023
Date Signed: 09/28/2023 05:41:16 PM

Document Has Been Signed on 09/28/2023 05:41 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FAITH CHAPEL INFANT CENTERFACILITY NUMBER:
376701490
ADMINISTRATOR:AMBER DELUCAFACILITY TYPE:
830
ADDRESS:9400 CAMPO ROADTELEPHONE:
(619) 567-7557
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 15TOTAL ENROLLED CHILDREN: 7CENSUS: 8DATE:
09/28/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:MIkayla GuzmanTIME COMPLETED:
01:15 PM
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On 9/28/23 at 12:30pm, Licensing Program Analyst (LPA), Martha Malane arrived at the facility to conduct a follow-up case management inspection for the purpose of a capacity increase and to add room 102 to the infant license. Upon arrival, LPA met with Assistant Director, Mikayla Guzman and was led on a tour the facility. There were seven (7) infant children and two (2) staff members present. Hours of operation are Monday through Friday 8:00am – 4:30pm.

Assistant Director provided LPA with the following updated documents: class schedules, updated LIC200A and outdoor waiver request letter. LPA took photos of the outdoor activity space.

Per Title 22, Division 12, Chapter 1, of the California Code of Regulations, no deficiencies were cited.

A capacity increase may be granted once an outdoor activity space waiver request is submitted and a final file review.

Exit interview conducted with Director, Mikayla Guzman. Notice of Site Visit shall be posted for 30 days from today's date. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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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