Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701070
Report Date: 04/13/2018
Date Signed 04/16/2018 01:31:12 PM

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:NATIVITY PRESCHOOL, THEFACILITY NUMBER:
376701070
ADMINISTRATOR:CHRISTINE GRUENFACILITY TYPE:
850
ADDRESS:6309 EL APAJO ROADTELEPHONE:
(858) 756-6763
CITY:RANCHO SANTA FESTATE: CAZIP CODE:
92067
CAPACITY:23CENSUS: 18DATE:
04/13/2018
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:13 AM
MET WITH:Christine GruenTIME COMPLETED:
12:00 PM
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Licensing Program Analyst, Rita Magana returned to the facility (see LIC 809 dated 4/10/18) to deliver an amended facility evaluation report.

It has been clarified that the licensee requires all its employees to be fingerprint cleared prior to working with the children, and, when Staff #1 was live scan printed on the evening of 4/10/18 staff #1's background clearance were processed almost immediately. The LIS database reflected a clearance date of 4/11/18.

This is an electronic copy of a handwritten report. Please see facility file for original signatures. The following information regarding ADA was provided: US Department Of Justice (USDOJ) toll-free ADA Information (800) 514-0301 (voice) (800) 514-0383(TTY) and link to publication: Commonly Asked Questions about Child Care Facilities and the ADA, available at: http://www.ada.gov/childqanda.htm Community Care Licensing: WEB SITE: http://www.ccld.ca.gov The report shall remain available at the facility for public review for three years. LIC 9213 was visibly posted today, for 30 days. The licensee was previously provided a copy of their appeal rights (LIC 9058, 12/15) and their signature on this form acknowledges receipt of these rights. Appeal must be received within 15 days.
SUPERVISOR'S NAME: Carl SheltonTELEPHONE: (619) 767-2205
LICENSING EVALUATOR NAME: Rita MaganaTELEPHONE: (616) 767-2213
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2018
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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