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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372005946
Report Date: 02/27/2020
Date Signed: 02/27/2020 05:44:30 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:ST. COLUMBA PRESCHOOLFACILITY NUMBER:
372005946
ADMINISTRATOR:PATRICIA GILSDORFFACILITY TYPE:
850
ADDRESS:3365 GLENCOLUM DRIVETELEPHONE:
(858) 279-0161
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY:60CENSUS: 10DATE:
02/27/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:35 PM
MET WITH:Fiona Bloemker-Preschool teacherTIME COMPLETED:
05:55 PM
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Licensing Program Analyst Selina Siao conducted an unannounced case management inspection to amend prior licensing report dated 12/16/2019. Upon arrival, there were 10 children supervised by three staff members. All staff members have the required background clearances and are associated to the facility. Current operating hours is Monday to Friday from 7:30am to 5pm.

Facility appears to be within substantial compliance during today's inspection. No citation issue.





Appeal Rights (1/16) were discussed and provided. Signature at the bottom of this report confirms receipt. Notice of Site Visit was posted during this visit and will remain posted for 30 days.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020
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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