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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701555
Report Date: 10/17/2023
Date Signed: 10/26/2023 09:57:57 AM

Document Has Been Signed on 10/26/2023 09:57 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:PURE HEART CHRISTIAN ACADEMY-PRESCHOOLFACILITY NUMBER:
376701555
ADMINISTRATOR:ADRIANA J SALDARRIAGAFACILITY TYPE:
850
ADDRESS:4110 PALM AVENUETELEPHONE:
(619) 212-2168
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 20TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
10/17/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Adriana SaldarriagaTIME COMPLETED:
10:39 AM
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On 10/17/23 at 10:00am, Licensing Program Analyst (LPA), Martha Malane met with applicant, Adriana Saldarriaga and Director, Marilyn Retiz 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 (NOIA).

Applicant, Adriana Saldarriaga submitted documents listed on the NOIA during the meeting. LPA reviewed and discussed the pending documents in detail with applicant, Adriana Saldarriagar and Director, Marilyn Retiz.

An exit interview was conducted with applicant, Adriana Saldarriagar and Director, Marilyn Retiz.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Martha Malane
LICENSING EVALUATOR SIGNATURE: DATE: 10/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/17/2023
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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