Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214409
Report Date: 11/28/2016
Date Signed: 11/28/2016 10:35:30 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:VILLAGE VALLEY PRESCHOOLFACILITY NUMBER:
426214409
ADMINISTRATOR:MARIA E. ANGULOFACILITY TYPE:
850
ADDRESS:3346 CONSTELLATION ROADTELEPHONE:
(805) 733-7330
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:18CENSUS: 11DATE:
11/28/2016
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Maria AnguloTIME COMPLETED:
10:40 AM
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Licensing Program Analysts (LPAs) Ruth Gull and Laura Villanueva made an unannounced CASE MANAGEMENT visit to the center regarding Licensee's request for an increase in capacity. Met with Maria Angulo, Licensee/Director and toured the indoor and outdoor space. The Licensee is requesting to increase the capacity to 23 children. The Fire clearance was granted on 10/19/16 for a capacity of 23. The Licensee will be using the existing 2 classrooms. The total square footage of the two classrooms is 820 square feet = 23 children. The outdoor playground area remains the same measurement at 2327 square feet = 31 children.

The center is licensed for 23 children effective today, 11/28/16.

There were no deficiencies cited during today's visit.

The LIC9213 (Notice of Site Visit) was posted during the visit.
SUPERVISOR'S NAME: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Ruth GullTELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:

DATE: 11/28/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2016
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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