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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600675
Report Date: 03/03/2025
Date Signed: 03/03/2025 01:47:56 PM

Document Has Been Signed on 03/03/2025 01:47 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
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:VI AT LA JOLLA VILLAGEFACILITY NUMBER:
374600675
ADMINISTRATOR/
DIRECTOR:		BOUDREAU, STEPHANIEFACILITY TYPE:
741
ADDRESS:8515 COSTA VERDE BLVDTELEPHONE:
(858) 646-7700
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY: 783TOTAL ENROLLED CHILDREN: 0CENSUS: 524DATE:
03/03/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Executive Director, Stephanie BoudreauTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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Licensing Program Analyst (LPA) Marisela Garcia-Centeno conducted a case management visit to deliver an amended report. LPA met with Executive Director, Stephanie Boudreau, and informed her of the purpose of the visit.

Today's visit is to deliver an amended report from complaint visit conducted on 2/28/2025.

The amended report was reviewed with Executive Director, Stephanie Boudreau and signatures were obtained. An exit interview was conducted, Appeal Rights (LIC 9058 03/22) along with a copy of this report was provided to Boudreau at the end of the visit.
Jennifer LottTELEPHONE: (619) 346-3976
Marisela Garcia-CentenoTELEPHONE: (619) 323-4834
DATE: 03/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/03/2025
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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