<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES
Community Care Licensing
FACILITY EVALUATION REPORT
Facility Number:
370806417
Report Date:
10/24/2019
Date Signed:
10/24/2019 12:57:55 PM
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
7575 METROPOLITAN DR., STE 110
SAN DIEGO
,
CA
92108
FACILITY NAME:
SUNSET STATE PRESCHOOL
FACILITY NUMBER:
370806417
ADMINISTRATOR:
EFRAIN BURCIAGA
FACILITY TYPE:
850
ADDRESS:
3825 SUNSET LANE
TELEPHONE:
(619) 428-4476
CITY:
SAN YSIDRO
STATE:
CA
ZIP CODE:
92173
CAPACITY:
72
CENSUS:
0
DATE:
10/24/2019
TYPE OF VISIT:
Collateral
UNANNOUNCED
TIME BEGAN:
12:35 PM
MET WITH:
Eugenia Teodoro
TIME COMPLETED:
01:05 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Yolanda Baez arrived at the Main Preschool Office located at 1880 Smythe Ave San Ysidro CA 92173. LPA Baez met with Eugenia Teodoro and obtained the staff files for every staff member that was observed to be at the facility when the Annual Inspection was conducted on 10/24/2019.
LPA Baez reviewed the files for all staff members from the annual that was conducted on 10/24/2019. The files were reviewed to ensure that all of the staff members have their current vaccines as per SB 792 and in compliance with AB1207. After an in depth review of the staff files it is determined that the immunization records and AB1207 for all staff members are in compliance.
No deficiencies were issued throughout today's file review.
An annual continuation will be conducted at the facility site.
SUPERVISOR'S NAME:
Tulam Vu
TELEPHONE:
(619) 767-2212
LICENSING EVALUATOR NAME:
Yolanda Baez
TELEPHONE:
(619) 767-2201
LICENSING EVALUATOR SIGNATURE:
DATE:
10/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
10/24/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809
(FAS) - (06/04)
Page:
1
of
1