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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364841216
Report Date: 02/11/2022
Date Signed: 02/11/2022 12:38:16 PM


Document Has Been Signed on 02/11/2022 12:38 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:BONANZA PRESCHOOL & KINDERGARTENFACILITY NUMBER:
364841216
ADMINISTRATOR:MELISSA WOJCIKFACILITY TYPE:
840
ADDRESS:14624 BONANZA ROADTELEPHONE:
(760) 241-7800
CITY:VICTORVILLESTATE: CAZIP CODE:
92392
CAPACITY:24CENSUS: 0DATE:
02/11/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Alicia Flores Site Coordinator TIME COMPLETED:
12:53 PM
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The Licensing Program Analysts (LPA's) Justin Dorsey and Steven Montoya conducted an unannounced Case Management visit. The purpose of the visit was to discuss a waiver request regarding the facility's indoor activity space. LPA's met with Site Coordinator Alicia Flores during this inspection.

A waiver is being requested for the usage of one the preschool classrooms (Pre-K class) during holiday's, breaks, Monday - Thursday from 2:30pm - 6:30pm and Friday 12:30pm - 6:30pm when not occupied by preschool children.

During the visit LPA Dorsey inspected school-age classroom and outdoor play area as well as the preschool classroom mentioned in the waiver. LPA Dorsey took pictures of the areas and received copies of the facility sketch and the schoolage programs schedule.



A copy of this report was discussed and left with Site Coordinator, Alicia Flores.



SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3318
LICENSING EVALUATOR NAME: Justin DorseyTELEPHONE: (661) 305-3012
LICENSING EVALUATOR SIGNATURE:
DATE: 02/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/11/2022
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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