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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701231
Report Date: 08/09/2023
Date Signed: 08/09/2023 05:08:05 PM

Document Has Been Signed on 08/09/2023 05:08 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:ALPINE CHILDREN'S ACADEMYFACILITY NUMBER:
376701231
ADMINISTRATOR:STEPHANIE FREEMANFACILITY TYPE:
850
ADDRESS:2403 ALPINE BOULEVARDTELEPHONE:
(619) 445-5462
CITY:ALPINESTATE: CAZIP CODE:
91901
CAPACITY: 50TOTAL ENROLLED CHILDREN: 50CENSUS: 14DATE:
08/09/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:41 PM
MET WITH:Stephanie FreemanTIME COMPLETED:
05:15 PM
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On 08/09/2023 at 3:46 PM, LPA Dana Stevens, conducted an unannounced case management for the purpose of a Technical Advisory noted during a complaint inspection. LPA met with Director, Stephanie Freeman. There were 14 children present with 2 staff at the time of the inspection.

Upon arrival LPA observed that an indoor play structure in the preschool room did not have cushioned flooring underneath the structure.

Technical Advisory cited on the attached LIC 9102 TA.

Notice of Site Visit must be posted for 30 days.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Dana Stevens
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2023
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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