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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700087
Report Date: 05/18/2022
Date Signed: 05/18/2022 01:07:54 PM


Document Has Been Signed on 05/18/2022 01:07 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
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108



FACILITY NAME:PEPPER VALLEY LEARNING CENTERFACILITY NUMBER:
376700087
ADMINISTRATOR:MICHELLE THOMPSONFACILITY TYPE:
850
ADDRESS:1358 PEPPER DRIVETELEPHONE:
(619) 444-7770
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:144CENSUS: 96DATE:
05/18/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:50 AM
MET WITH:Michelle ThompsonTIME COMPLETED:
01:15 PM
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On 05/18/2022 at 10:50am, Licensing Program Analyst (LPA) Selina Siao conducted an inspection today regarding a self reported alleged incident that happened on 05/03/2022 between two day care children at the playground. The incident was reported to the department over the phone within the required 24 hours and a written incident report was received on 05/09/2022. Upon arrival, LPA Siao met with Director Michelle Thompson and conducted a tour of the preschool classrooms to gather census. Appropriate ratios were observed during the tour and all staff members have the required background clearances and are associated to the facility.

Interviews were conducted with several staff members and a day care child during today's inspection. The outdoor playground area was also tour today. Further review of this incident to be completed to finalize the issue, no violations are issued to the facility regarding this issue at this time.

Appeal Rights (1/16) were discussed and provided. 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: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2022
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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