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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700971
Report Date: 06/14/2024
Date Signed: 06/14/2024 02:40:00 PM

Document Has Been Signed on 06/14/2024 02:40 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:COTTONTAIL PRESCHOOLFACILITY NUMBER:
376700971
ADMINISTRATOR/
DIRECTOR:		DENISE MATTHEWSFACILITY TYPE:
850
ADDRESS:471 E STREETTELEPHONE:
(619) 425-3107
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 49TOTAL ENROLLED CHILDREN: 49CENSUS: 23DATE:
06/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Denise MatthewsTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On 6/14/24 at 1:15pm, Licensing Program Analyst (LPA) Adrian Castellon conducted an unannounced case management inspection. LPA Castellon met with director Denise Matthews. The purpose of the inspection is to deliver amended complaint reports regarding an inspection conducted on 4/05/24.

This report will be used to memorialize the inspection. One Amended LIC9099 and one LIC9099 added to proper complaint complaint delivered on this date.

A Notice of Site Visit was given and must remain posted on, or immediately next to, interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Castellon returned on this date as report was not given on 5/17/24. Director Ana King signed the report on this date.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2024
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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