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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600360
Report Date: 01/22/2020
Date Signed: 01/22/2020 05:13:48 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:KINDERCARE AGEE PRESCHOOLFACILITY NUMBER:
376600360
ADMINISTRATOR:BIBIANCA JIMENEZFACILITY TYPE:
850
ADDRESS:6150 AGEE STREETTELEPHONE:
(858) 453-7530
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:84CENSUS: 72DATE:
01/22/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Audrey Lejarde TIME COMPLETED:
05:25 PM
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Licensing Program Analysts (LPAs) Elizabeth Rivera and Joelle Redding, made an unannounced visit to follow up on a self-reported incident, reported by staff on 12/19/19, wherein a 2 year old child (Child #1) was inappropriately disciplined.

LPAs spoke with the Program Specialist, Jemina Gray and Assistant Director, Audrey Lejarde and conducted interviews with Staff #1 through Staff #5. Program Specialist and Assistant Director provided LPAs a copy of the parent contact roster and pertinent documentation.

No deficiencies are cited at this time. A Notice of Site Visit was posted today, and must remain posted for a period or 30 days. 
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Elizabeth RiveraTELEPHONE: (619) 767-2232
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2020
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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