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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701527
Report Date: 01/19/2023
Date Signed: 01/19/2023 09:58:20 AM

Document Has Been Signed on 01/19/2023 09:58 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
MISSION VALLEY, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:VILLAGE PRESCHOOLFACILITY NUMBER:
376701527
ADMINISTRATOR:EILEEN RODRIGUEZFACILITY TYPE:
850
ADDRESS:600 6TH STREETTELEPHONE:
(619) 522-8915
CITY:CORONADOSTATE: CAZIP CODE:
92118
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 15DATE:
01/19/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Maritza Arellano, Administrative Assistant of Special ProgramsTIME COMPLETED:
10:15 AM
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On 1/19/2023 at 9:35 am, Licensing Program Analyst (LPA) Michelle Hood completed an unannounced case management inspection for the purpose of delivering an amended report from an original report dated, 01/17/2023, due to the signature and correction for classroom #710. LPA met with Maritza Arellano, Administrative Assistant of Special Programs. Also present were 15 children with three staff.

No deficiencies. Appeal Rights LIC 9058 were provided. The Notice of Site visit was provided and will remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/19/2023
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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