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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600311
Report Date: 02/27/2023
Date Signed: 02/27/2023 04:27:29 PM


Document Has Been Signed on 02/27/2023 04:27 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:KINDERCARE ROTHGARD - INFANTFACILITY NUMBER:
376600311
ADMINISTRATOR:CELIA CARRIZOSAFACILITY TYPE:
830
ADDRESS:10130 ROTHGARD ROADTELEPHONE:
(619) 670-6566
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:23CENSUS: 11DATE:
02/27/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:55 PM
MET WITH:Celia CarrizosaTIME COMPLETED:
04:35 PM
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On 2/27/2023 at 3:55 pm, Licensing Program Analyst (LPA), Vicky Williamson conducted an unannounced case management inspection to deliver an amended report originally created on 2/13/2023. Upon arrival LPA met with Director, Celia Carrizosa and explained the purpose of the inspection. Present in the facility were 11 children and three (3) staff members.

No deficiencies cited. An exit interview was conducted with the Director, Celia Carrizosa. Notice of Site Visit was given and must remain posted for 30 days. LPA observed the Director post the Notice of Site Visit on the bulletin board. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Vicky WilliamsonTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:
DATE: 02/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/27/2023
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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