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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600490
Report Date: 02/24/2023
Date Signed: 02/24/2023 01:25:58 PM

Document Has Been Signed on 02/24/2023 01:25 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:EASTLAKE COMMUNITY CHURCH PRESCHOOLFACILITY NUMBER:
376600490
ADMINISTRATOR:SHERRIANN KELLYFACILITY TYPE:
850
ADDRESS:2351 OTAY LAKES ROADTELEPHONE:
(619) 421-4156
CITY:CHULA VISTASTATE: CAZIP CODE:
91915
CAPACITY: 174TOTAL ENROLLED CHILDREN: 174CENSUS: 84DATE:
02/24/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Sherriann KellyTIME COMPLETED:
01:30 PM
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On 02/24/23, LPA Edgar Campana conducted an unannounced Case Management inspection to finalize approval of room 12 for facility use. Tour of facility was conducted and census was taken.

Fire clearance was granted for rooms 1-13 on 02/06/23. Room 12 is now approved for facility use.

No deficiencies cited during today's visit.

Exit interview conducted and report reviewed and given to director, Sherriann Kelly.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2023
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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