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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105015
Report Date: 01/17/2020
Date Signed: 01/17/2020 10:06:54 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:INTELLICHILDREN MONTESSORI INSTITUTEFACILITY NUMBER:
376105015
ADMINISTRATOR:BRANDY LEE PEARCEFACILITY TYPE:
830
ADDRESS:212 WEST SAN MARCOS BOULEVARDTELEPHONE:
(760) 471-0221
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY:24CENSUS: 0DATE:
01/17/2020
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:01 AM
MET WITH:Janet AndradeTIME COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Yolanda Baez met with Applicant, Janet Andrade, at the San Diego Child Care Regional Office to comply with Component II orientation requirements.

Applicant has submitted all pending documents as of 01/07/2020 and STD850 was received on 01/16/2020.

Pre-licensing process was discussed with Applicant. Pre-licensing inspection was scheduled for 01/21/2020 at 11am.

SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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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