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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334811267
Report Date: 11/04/2021
Date Signed: 11/04/2021 10:46:50 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LEUSD HEALD ACADEMY CENTER PRESCHOOLFACILITY NUMBER:
334811267
ADMINISTRATOR:ADRIA GALARZAFACILITY TYPE:
850
ADDRESS:601 W. HEALD STREETTELEPHONE:
(951) 253-7660
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92530
CAPACITY:63CENSUS: 24DATE:
11/04/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sarah YatesTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Joanne Domingo arrived at the facility to deliver findings for another LEUSD facility investigation. LPA Domingo toured the facility and met with CFS Supervisor, Sarah Yates.

No Deficiencies were cited during this visit.

An exit interview was conducted, and this report was reviewed with CFS Supervisor, Sarah Yates. Appeal rights were discussed and provided during the exit interview.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Joanne DomingoTELEPHONE: (951) 233-9356
LICENSING EVALUATOR SIGNATURE:

DATE: 11/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2021
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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