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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105046
Report Date: 10/14/2021
Date Signed: 10/14/2021 11:37:54 AM

Document Has Been Signed on 10/14/2021 11:37 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:PRIMROSE SCHOOLS 4S RANCHFACILITY NUMBER:
376105046
ADMINISTRATOR:BREEANNA MOTAFACILITY TYPE:
850
ADDRESS:17025 VIA DEL CAMPOTELEPHONE:
(858) 592-2335
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY: 164TOTAL ENROLLED CHILDREN: 164CENSUS: 26DATE:
10/14/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Reena DayalTIME COMPLETED:
12:00 PM
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On 10/14/21 Licensing Program Analyst Michael Morales-DeSilvestore conducted an unannounced case management visit for the purpose of inspecting the new preschool play structure. During the visit their were 26 preschool children in care.

Facility play structure was inspected today for age appropriateness and proper cushioning. LPA obtained a copy of the structure invoice with the individual pieces rated for ages 2-12. Proper rubber cushioning was observed.

LPA reviewed current county health order and mask mandate with the Director and Owner.

Facility was provided a notice of site visit and appeal rights. Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Michael Morales-DeSilvestore
LICENSING EVALUATOR SIGNATURE: DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/14/2021
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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