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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370805244
Report Date: 12/01/2022
Date Signed: 12/01/2022 04:07:13 PM

Document Has Been Signed on 12/01/2022 04:07 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:ASSOCIATED STUDENTS CHILD CARE CENTER INFANT CTRFACILITY NUMBER:
370805244
ADMINISTRATOR:MICHELLE ZAMORAFACILITY TYPE:
830
ADDRESS:5500 CAMPANILE DRIVETELEPHONE:
(619) 594-7941
CITY:SAN DIEGOSTATE: CAZIP CODE:
92182
CAPACITY: 64TOTAL ENROLLED CHILDREN: 64CENSUS: 27DATE:
12/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:16 PM
MET WITH:Michelle ZamoraTIME COMPLETED:
01:30 PM
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On 12/01/2022 at 1:16pm, Licensing Program Analyst (LPA) Samantha Clenista conducted an unannounced case management inspection to deliver an amended report dated 12/01/2022 at 10am. LPA met with Director, Michelle Zamora. Also present in the facility were 27 children and 14 teachers/staff. Facility was within ratio & capacity. See file for amended report.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Samantha Clenista
LICENSING EVALUATOR SIGNATURE: DATE: 12/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/01/2022
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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