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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700264
Report Date: 11/15/2022
Date Signed: 11/15/2022 12:04:59 PM


Document Has Been Signed on 11/15/2022 12:04 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:SAN PASQUAL UNION PRESCHOOLFACILITY NUMBER:
376700264
ADMINISTRATOR:MARK BURROUGHSFACILITY TYPE:
850
ADDRESS:15305 ROCKWOOD ROADTELEPHONE:
(760) 745-4931
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY:30CENSUS: 21DATE:
11/15/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Rhonda BrownTIME COMPLETED:
12:15 PM
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Licensing Program Analyst's (LPA) Sumayya Habeebulla came to the above facility to conduct an annual inspection today and was greeted by Ms. Rhonda Brown. LPA toured the facility and completed file record reviews but was unable to complete the inspection report due to computer technical difficulties with Care Tools Excel Software. LPA will come at a later date to deliver the report.

Facility will be closed for Thanksgiving Holidays from Nov 21 to Nov 25.

An exit interview was conducted with the Ms. Rhonda Brown, Appeal Right and a notice of site was provided. Notice of site visit shall be posted for 30 days.
SUPERVISOR'S NAME: Carlos MartinezTELEPHONE: (951) 782-4950
LICENSING EVALUATOR NAME: Sumayya HabeebullaTELEPHONE: 951-201-1991
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
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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