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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700971
Report Date: 11/13/2020
Date Signed: 11/13/2020 10:45:48 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:COTTONTAIL PRESCHOOLFACILITY NUMBER:
376700971
ADMINISTRATOR:DENISE MATTHEWSFACILITY TYPE:
850
ADDRESS:471 E STREETTELEPHONE:
(619) 425-3107
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:49CENSUS: 18DATE:
11/13/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Denise MatthewsTIME COMPLETED:
10:15 AM
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Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management visit to amend the prior 11/09/2020 licensing report. Due to the COVID 19 outbreak, this inspection was done as a tele visit upon the FaceTime platform. Present were the Licensee, three (3) staff members and eighteen (18) preschool children.

The licensing report, dated 11/09/2020, reported that ten (10) daycare children were contacted however in actuality eleven (11) daycare children were contacted. The amended 11/09/2020 Licensing report reflects eleven (11) daycare children were contacted. At this tele visit, visit, both the prior and corrected reports were discussed by staff and LPA. Staff was electronically provided with a copy of the corrected report and corrected LIC 811 Confidential Names document. The Licensee was advised that email acknowledgement of the receipt of this amended report and amended LIC 811 is to be received within twenty-four hours.

A Notice of Site Visit (LIC 9213) is to be posted for thirty (30) days. LPA electronically provided Licensee with the LIC 9213. An exit interview was conducted. A copy of this report and Licensee/Appeal Rights (LIC 9058) will be e-mailed to the Licensee. The Licensee was advised that email acknowledgement of the receipt of the report is to be received within twenty-four hours.

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2020
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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