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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105016
Report Date: 08/24/2021
Date Signed: 09/20/2021 08:20:58 AM

Document Has Been Signed on 09/20/2021 08:20 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:INTELLICHILDREN MONTESSORI INSTITUTEFACILITY NUMBER:
376105016
ADMINISTRATOR:BRANDY LEE PEARCEFACILITY TYPE:
850
ADDRESS:212 WEST SAN MARCOS BOULEVARDTELEPHONE:
(760) 471-0221
CITY:SAN MARCOSSTATE: CAZIP CODE:
92069
CAPACITY: 90TOTAL ENROLLED CHILDREN: 0CENSUS: 31DATE:
08/24/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Director Brandy PearceTIME COMPLETED:
12:20 PM
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On 8/24/21 @ 12:10 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to deliver amended LIC 9099's from 7/13/21 and 8/3/21. LPA mistakenly omitted that interviews with children were conducted during these visits. The amended reports reflect the correction.
SUPERVISORS NAME: Renesha Pack
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 08/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/24/2021
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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