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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700393
Report Date: 02/08/2022
Date Signed: 02/08/2022 10:44:45 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:LINDA VISTA STATE PRESCHOOLFACILITY NUMBER:
376700393
ADMINISTRATOR:NINA MAURICA-DIXONFACILITY TYPE:
850
ADDRESS:2772 ULRIC STREETTELEPHONE:
(858) 800-5450
CITY:SAN DIEGOSTATE: CAZIP CODE:
92111
CAPACITY:24CENSUS: 19DATE:
02/08/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Josephine CondraTIME COMPLETED:
11:00 AM
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On 2/8/22, Licensing Program Analyst Michael Morales-DeSilvestore met with Resource Teacher Josephine Condra for the purpose of measuring Room 10. The facility will be moving their program from room 30 to building 200 room 10. LPA observed 19 children in care today. Facility is following the current mask order. Facility is expecting to move to the new room on 2/14/22

LPA measured room 10 to be 884.79 square feet which is sufficient for 25 children. The outdoor space is located right outside the classroom and measured 1,800 square feet which is sufficient for 24 children. Facility has a bathroom located outside of room 10 with 7 toilets and 5 sinks which is sufficient for 75 children. Fire clearance was granted on 2/1/22 for 24 children.

Room change will be approved pending bathroom waiver.

Josephine Condra was provided a copy of this report, appeal rights (LIC 9058 12/15) and notice of site visit and their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 767-2242
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestoreTELEPHONE: (619) 767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2022
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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