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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
304370358
Report Date:
07/23/2019
Date Signed:
07/23/2019 11:50:19 AM
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:
TUSD/KINDERGARTEN READINESS ACADEMY-HEIDEMAN
FACILITY NUMBER:
304370358
ADMINISTRATOR:
TORRES, ANA
FACILITY TYPE:
850
ADDRESS:
15571 WILLIAMS STREET
TELEPHONE:
(714) 730-7521
CITY:
TUSTIN
STATE:
CA
ZIP CODE:
92780
CAPACITY:
24
CENSUS:
0
DATE:
07/23/2019
TYPE OF VISIT:
Case Management - Licensee Initiated
UNANNOUNCED
TIME BEGAN:
09:05 AM
MET WITH:
Lauralee Cabibi
TIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) S. Hawkins arrived at the facility and met with district representative Lauralee Cabibi. This was an announced case management-licensee initiated visit for a capacity increase. Due to computer malfunction a report could not be generated and completed. LPA will follow up on a future date to complete the inspection.
This is an electronic copy of a written report which was signed by the representative.
SUPERVISOR'S NAME:
Rina Lopez
TELEPHONE:
(714) 703-2808
LICENSING EVALUATOR NAME:
Sherene Hawkins
TELEPHONE:
(714) 703-2821
LICENSING EVALUATOR SIGNATURE:
DATE:
07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/23/2019
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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