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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600031
Report Date: 07/16/2024
Date Signed: 07/16/2024 08:38:41 AM

Document Has Been Signed on 07/16/2024 08:38 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CARMEL VALLEY PRESCHOOLFACILITY NUMBER:
376600031
ADMINISTRATOR/
DIRECTOR:		HOLLY SMITHFACILITY TYPE:
850
ADDRESS:13340 HAYFORD WAYTELEPHONE:
(858) 481-7933
CITY:SAN DIEGOSTATE: CAZIP CODE:
92130
CAPACITY: 125TOTAL ENROLLED CHILDREN: 125CENSUS: DATE:
07/16/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Brianna DepewTIME VISIT/
INSPECTION COMPLETED:
08:45 AM
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On 7/16/24 at 8:15 am LPA Annette Sutherland conducted an unannounced Case Management inspection for the purpose of providing an Amended report originally provided on 5/30/24. At arrival LPA met with Brianna Depew. There were 20 children with 6 staff. Facility was within ratio and capacity.

Amended 5/20/24 report were provided. No deficiencies were cited.

Exit Interview conducted and report was reviewed with the facility.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 07/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/16/2024
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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