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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701553
Report Date: 08/15/2023
Date Signed: 09/20/2023 09:07:12 AM

Document Has Been Signed on 09/20/2023 09:07 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FOUR SEASONS ACADEMY LLCFACILITY NUMBER:
376701553
ADMINISTRATOR:ANGIE NORIEGAFACILITY TYPE:
850
ADDRESS:3702 DEL SOL BLVD STE ATELEPHONE:
(619) 909-1845
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 80TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
08/15/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:53 AM
MET WITH:Angie NoriegaTIME COMPLETED:
11:05 AM
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On 8/15/23 at 9:53am, Licensing Program Analyst (LPA), Martha Malane met with Applicant, Angie Noriega and Assistant, Brianna Lopez for an office meeting at the San Diego Regional Office. 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, Angie Noriega and Assistant, Brianna Lopez.

An exit interview was conducted with Applicant, Angie Noriega.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/15/2023
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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