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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105015
Report Date: 10/24/2022
Date Signed: 10/24/2022 12:02:39 PM

Document Has Been Signed on 10/24/2022 12:02 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:INTELLICHILDREN MONTESSORI INSTITUTEFACILITY NUMBER:
376105015
ADMINISTRATOR:BRANDY PEARCEFACILITY TYPE:
830
ADDRESS:212 WEST SAN MARCOS BOULEVARDTELEPHONE:
(760) 471-0221
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 20TOTAL ENROLLED CHILDREN: 10CENSUS: 6DATE:
10/24/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Janet AndradeTIME COMPLETED:
11:00 AM
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On October 24, 2022 at 10:45 a.m. Licensing Program Analyst (LPA) Leilani Curtis conducted an unannounced case management inspection for the purpose of delivering an amended report, LIC 9099C and LIC9099D, from an original report dated, 10/11/22. Upon arrival LPA met with Licensee Janet Andrade and proceeded to tour the facility. During this inspection there were 6 children present with 2 staff members. The facility is within licensed capacity/ratio limitations. Staff members have the required background clearances and are associated to the facility.

During the 10/11/22 inspection the Licensee was cited a Type B violation for violating California Code of Regulations, Title 22, 101223(a)(3). After management review it was determined that the citation should be classified as a Type A violation.

No new deficiencies cited at today's inspection

An exit interview was conducted with Licensee Andrade and Appeal Rights (LIC 9058) were discussed. The director's signature on this form acknowledges receipt of these rights. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA observed the director post notice of site visit.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Grace Curtis
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2022
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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