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Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
304370981
Report Date:
05/07/2021
Date Signed:
05/07/2021 02:58:40 PM
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:
GRATITUDE GARDEN PRESCHOOL
FACILITY NUMBER:
304370981
ADMINISTRATOR:
RICE, ERIN
FACILITY TYPE:
850
ADDRESS:
92 AVENIDA LA PATA
TELEPHONE:
(949) 572-4453
CITY:
SAN CLEMENTE
STATE:
CA
ZIP CODE:
92673
CAPACITY:
55
CENSUS:
27
DATE:
05/07/2021
TYPE OF VISIT:
Case Management - Other
UNANNOUNCED
TIME BEGAN:
02:00 PM
MET WITH:
Erin Rice - Director
TIME COMPLETED:
03:00 PM
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Tele-inspection due to COVID 19 State of Emergency
Licensing Program Analyst (LPA) Ryan Chan conducted a tele inspection at the facility. LPA met with Director Erin Rice. A facility tour was conducted and census was taken. The purpose of the tele inspection is to deliver an amended report for an inspection dated 03/08/2019
where the citation
has been updated from type A to type B violation.
Exit interview was conducted. A copy of this report will be provided through email and the licensee’s signature on this form acknowledges receipt of the report. (The "Read Receipt" or licensee's email is in lieu of a signature). The Notice of Site Visit was not posted due to tele-investigation Covid-19 State of Emergency.
SUPERVISOR'S NAME:
Rina Lopez
TELEPHONE:
(714) 703-2808
LICENSING EVALUATOR NAME:
Ryan Joseph Chan
TELEPHONE:
(714) 287-0708
LICENSING EVALUATOR SIGNATURE:
DATE:
05/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/07/2021
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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