<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701097
Report Date: 02/02/2023
Date Signed: 02/02/2023 12:30:15 PM


Document Has Been Signed on 02/02/2023 12:30 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:MARILLA-LAKESIDE EARLY ADVANTAGE PRESCHOOLFACILITY NUMBER:
376701097
ADMINISTRATOR:ROBYN BOWMANFACILITY TYPE:
850
ADDRESS:9745 MARILLA DRIVETELEPHONE:
(619) 390-2391
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY:97CENSUS: 46DATE:
02/02/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Director, Robyn Bowman TIME COMPLETED:
11:25 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analysts, (LPAs) Jennifer Lott and Nancy Diaz made an unannounced Case Management visit for a request for decrease in capacity. LPA's identified themselves and were granted entry by Director, Robyn Bowman after disclosing the purpose of their visit.

The purpose of LPA's visit was for a decrease in capacity because licensee removed the use of room #3. Licensee submitted the LIC 200 - Application for Child Care License, as well as the floor plans. Observed today were 46 children.

Licensee states they will be using the following rooms/square footage:
Room #4 - 774 SF
Room # 5 - 774 SF
Room # ESS Room - 1,090 SF

Total Square Footage - 2,638 SF which will accommodate 75 children.

The facility has 6 toilets and 6 sinks. The decrease in capacity is granted for 75 children. effective 02/02/2023.

No deficiencies were observed during this visit. An exit interview conducted and a notice of site visit was given. Notice of site visit must be posted for 30 days.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1