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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701537
Report Date: 10/13/2022
Date Signed: 10/13/2022 12:28:05 PM

Document Has Been Signed on 10/13/2022 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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:ADVENTURES IN MONTESSORI OCEAN BEACHFACILITY NUMBER:
376701537
ADMINISTRATOR:TANNIA FAJARDOFACILITY TYPE:
850
ADDRESS:4735 SANTA CRUZ AVE.TELEPHONE:
(619) 215-6159
CITY:SAN DIEGOSTATE: CAZIP CODE:
92107
CAPACITY: 46TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/13/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Tannia FajardoTIME COMPLETED:
12:00 PM
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On 10/13/22 at 10:30am, Licensing Program Analyst (LPA), Martha Malane met with applicant, Tannia Fajardo. Also present was applicant’s husband, Jeff Kimaya. The purpose of today's meeting was to review pending documents listed on the LIC184C - Notice of Incomplete Application.

LPA reviewed and discussed the pending documents in detail with applicant Tannia Fajardo.
An exit interview was conducted with applicant Tannia Fajardo.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 10/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/13/2022
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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