<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376300358
Report Date: 11/16/2023
Date Signed: 11/16/2023 11:34:45 AM

Document Has Been Signed on 11/16/2023 11:34 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:COLES COTTAGE ACADEMYFACILITY NUMBER:
376300358
ADMINISTRATOR:COSTA,WEERATUNGAFACILITY TYPE:
850
ADDRESS:505 CIVIC CENTER DRTELEPHONE:
(949) 836-4465
CITY:VISTASTATE: CAZIP CODE:
92084
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 31DATE:
11/16/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Office Manager Brenda MesaTIME COMPLETED:
10:45 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On November 16, 2023 at 9:45 am, Licensing Program Analyst (LPA) Jessica Rubio arrived unannounced to Coles Cottage Academy (CCC). LPA met with Office Manager Brenda Mesa. LPA conducted a tour and census of all classrooms. LPA also reviewed the Classroom Roster and the current menu. LPA observed the two year old classroom with twelve children and two teachers providing care, the three year old classroom with eight children and one teacher providing care and the four year old classroom with eleven children and one teacher providing care. All classes were in ratio at the time of inspection. There were no deficiencies cited at this time. An exit interview was conducted and this report was reviewed with Office Manager Brenda Mesa. A notice of site visit was also provided and must remain posted for 30 days.
SUPERVISORS NAME: Pauline Beschorner
LICENSING EVALUATOR NAME: Jessica M Rubio
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1