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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 372001648
Report Date: 05/03/2024
Date Signed: 05/03/2024 09:28:04 AM

Document Has Been Signed on 05/03/2024 09:28 AM - 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:SILVERMAN PRESCHOOL OF TIFERETH ISRAEL SYNAGOGUEFACILITY NUMBER:
372001648
ADMINISTRATOR/
DIRECTOR:		JENNIFER LOWFACILITY TYPE:
850
ADDRESS:6660 COWLES MOUNTAIN BOULEVARDTELEPHONE:
(619) 697-1948
CITY:SAN DIEGOSTATE: CAZIP CODE:
92119
CAPACITY: 89TOTAL ENROLLED CHILDREN: 89CENSUS: DATE:
05/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Antonio ParkerTIME VISIT/
INSPECTION COMPLETED:
09:50 AM
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On 5/3/24, LPA Patrick Ma conducted a case management visit to deliver an amended LIC 9099 reports, originally delivered on 2/22/24 and 3/8/24.

Report was reviewed with the facility representative, Antonio Parker. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2024
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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