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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300022
Report Date: 08/17/2022
Date Signed: 08/17/2022 03:08:09 PM


Document Has Been Signed on 08/17/2022 03:08 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:LITTLE LAMB'S PRESCHOOLFACILITY NUMBER:
336300022
ADMINISTRATOR:AMY-RUTH BOCKMANFACILITY TYPE:
850
ADDRESS:21901 RAILROAD CANYON RDTELEPHONE:
(951) 471-3807
CITY:LAKE ELSINORESTATE: CAZIP CODE:
92532
CAPACITY:79CENSUS: 50DATE:
08/17/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:06 PM
MET WITH:Lacey RomeynTIME COMPLETED:
03:45 PM
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Licensing Program Analysts (LPAs) Ana Noble and Lorena Valenzuela arrived at the facility to conducted a Case Management visit regarding recent organizational changes that have taken place to the Licensee and Director. In April of this year 2022, the facility contacted the department to obtain information on the required information needed to update the Department with these changes. A list of required documents and information was provided to George Garcia, new licensee as of this date not all of the required documents have been submitted to the Department as requested previously.

The following items are being requested and must be submitted to the Department no later than August 31, 2022:

1. Administrative Organization, LIC309 (Previous one submitted Terms of Board Members/Directors have expired).
2. Updated Board Resolution/Board Meeting Minutes identifying George Garcia, as the authorized Licensee and Lacey Romeyn as the Director.
3. Certificate of Completion of Online Orientation Component III (Operations and Record keeping) for George Garcia, Licensee and Lacey Romeyn, Director.
4. Updated Application of Child Care Center, LIC200A

If all items are not received by the indicated date of August 31, 2022, an office conference will be scheduled with Management.

Exit interview was conducted with the Lacey Romeyn, Director and copy of this report and appeal right provided during this visit. All reports must be maintained and available for public review for a total of 3 years.
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Ana NobleTELEPHONE: (951) 295-5832
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022
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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