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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372002147
Report Date: 06/07/2019
Date Signed: 06/07/2019 09:23:01 AM

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:MONTESSORI SCHOOL HOUSEFACILITY NUMBER:
372002147
ADMINISTRATOR:STONEMAN, DENAFACILITY TYPE:
850
ADDRESS:4544 POCAHONTAS AVENUETELEPHONE:
(858) 270-9350
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY:77CENSUS: 20DATE:
06/07/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
07:50 AM
MET WITH:Dena Stoneman, DirectorTIME COMPLETED:
08:25 AM
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Licensing Program Analyst, Michelle Hood, made an unannounced inspection to evaluate changes to the preschool playground made over the summer.

The old existing play structures were removed and new Play & Park structures were installed. New woodchips were placed around the play structures. (see photos)

The cushioning is sufficient and the play equipment is age appropriate. No hazards were noted and the playground is approved for use.

LPA observed licensee post form LIC 9213. NOTICE OF SITE VISIT IS TO BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (559) 243-4588
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 06/07/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2019
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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