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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100003
Report Date: 08/17/2020
Date Signed: 08/17/2020 10:35:39 AM

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:FELIX, ELISA FAMILY CHILD CAREFACILITY NUMBER:
376100003
ADMINISTRATOR:ELISA FELIXFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 300-7379
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:14CENSUS: 0DATE:
08/17/2020
TYPE OF VISIT:Case Management - IncidentANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Elisa FelixTIME COMPLETED:
10:34 AM
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On 8/17/20 at 10:15 AM, Licensing Program Analyst (LPA) Keturah Lane, conducted an announced Case Management Tele-Inspection visit regarding a child in care who tested positive for COVID-19 at this facility. Due to COVID-19, a tele-inspection was conducted using Zoom to tour the facility. Licensee Elisa Felix was present at the tele-inspection.

Census at time of report was 0 children because the facility was closed. Licensee decided to close the facility on 8/10/20 and the last day the children were in care was 8/7/20. Child was reported with symptoms on 8/7/20 and tested positive (presumptive) on 8/13/20. Licensee called Epidemiology on 8/13/20 and it was recommended that she keep the facility closed at this time and re-open on 9/7/20. Licensee reported positive covid-19 case to Licensing on 8/13/20 through the duty line. Licensee stated she is receiving the recent PINs and information from the Department via e-mail. Census on the last day of care which was 8/7/20 was 6 children.

LPA Lane will continue to follow up with Licensee on the facility's situation. LPA advised Licensee to submit LIC624b Unusual Incident report as required. LPA requested a copy of the facility roster and received it via e-mail from Licensee today (8/17/20).

An exit interview was conducted with the Licensee. Appeal Rights were discussed and provided. Facility was advised to post the Notice of Site Visit for 30 days. A copy of the report, appeal rights and notice of site visit will be e-mailed to the facility and Licensee was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2020
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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