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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700698
Report Date: 02/02/2022
Date Signed: 02/02/2022 01:26:35 PM

Document Has Been Signed on 02/02/2022 01:26 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:NORTH COAST CHURCH PRESCHOOLFACILITY NUMBER:
376700698
ADMINISTRATOR:MARCIA BOECHEFACILITY TYPE:
850
ADDRESS:2405 NORTH SANTA FE AVENUETELEPHONE:
(760) 330-9200
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY: 165TOTAL ENROLLED CHILDREN: 165CENSUS: DATE:
02/02/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Marcia Boece, DirectorTIME COMPLETED:
01:35 PM
NARRATIVE
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On the date and time listed, Licensing Program Analysts (LPAs), Nasha King, Sumayya Habeebulla, and Ana Noble made an unannounced Case Management visit to deliver an amended LIC 9099. The original report was delivered on 01/19/2022, and one of the two complaint allegations were substantiated, but the report was made confidential. The amended report now reflects that the report has been made public; no additional changes were made to the report.

LPAs conducted COVID-19 screening questions prior to/upon entering the facility with the Director, Marcia Boece, and informed Ms. Boece of the purpose for the visit. During this visit, LPAs toured the facility and conducted census.

An exit interview was conducted, and a Notice of Site visit was issued, along with a copy of this report and the amended complaint report was provided to the Director. There are no deficiencies being cited at this time.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Nasha King
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2022
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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