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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370800323
Report Date: 02/02/2023
Date Signed: 02/02/2023 12:30:51 PM

Document Has Been Signed on 02/02/2023 12:30 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:LAKESIDE PRESB PRESCHOOL & CHILDREN'S CENTERFACILITY NUMBER:
370800323
ADMINISTRATOR:SHAWN SANTOFACILITY TYPE:
850
ADDRESS:9908 CHANNEL ROADTELEPHONE:
(619) 443-2887
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 135TOTAL ENROLLED CHILDREN: 27CENSUS: 22DATE:
02/02/2023
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director, Shawn Santo TIME COMPLETED:
10:35 AM
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Licensing Program Analysts, (LPAs) Jennifer Lott and Nancy Diaz made an announced Case Management visit for a request for decrease in capacity. LPA's identified themselves and were granted entry by Director, Shawn Santo after disclosing the purpose of their visit.
The purpose of LPA's visit was for a decrease in capacity. Licensee submitted the LIC 200 - Application for Child Care License, as well as the floor plans. Observed today were 21 children.

Licensee states they will be using the following rooms/square footage:
Room #4 - 483 SF
Room # 5 - 483 SF
Room # 6 - 644 SF
Room # 7 - 644 SF
Room # 9 - 361 SF
Fellowship Hall - 1633 SF

Total Square Footage - 4, 248 SF which will accommodate 121 children.

The facility has 7 toilets, 1 urinal and 6 sinks. The decrease in capacity is granted for 90 children effective 02/02/2023.

No deficiencies were observed during this visit. An exit interview conducted and a notice of site visit was given. Notice of site visit must be posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2023
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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