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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700264
Report Date: 12/01/2022
Date Signed: 12/01/2022 12:28:39 PM

Document Has Been Signed on 12/01/2022 12:28 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:SAN PASQUAL UNION PRESCHOOLFACILITY NUMBER:
376700264
ADMINISTRATOR:MARK BURROUGHSFACILITY TYPE:
850
ADDRESS:15305 ROCKWOOD ROADTELEPHONE:
(760) 745-4931
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 30TOTAL ENROLLED CHILDREN: 40CENSUS: 19DATE:
12/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Rhonda BrownTIME COMPLETED:
12:45 PM
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Licensing Program Analyst (LPAs) Sumayya Habeebulla and Ana Noble returned on this date to deliver reports to the facility for visit conducted on 11/15/22. LPA Habeebulla was unable to complete the inspection report on 11/15/22 due to computer technical difficulties with Care Tools Excel Software and has returned to provide copies of reports on this date.

An exit interview was conducted with the Facility Representative Rhonda Brown, and a copy of this report was issued during this visit. A notice of Site Visit was provided which must be posted for 30 days.

A copy of this report must be made available to the public for 3 years.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Sumayya Habeebulla
LICENSING EVALUATOR SIGNATURE: DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/30/2022
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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