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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100003
Report Date: 07/23/2021
Date Signed: 07/23/2021 08:38:44 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: 7DATE:
07/23/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Elisa FelixTIME COMPLETED:
08:50 AM
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On 7/23/21 at 8:25 AM, Licensing Program Analyst (LPA) Keturah Lane conducted an unannounced case management visit for the purpose of delivering an amended report. Upon arrival, LPA Lane met with Licensee Elisa Felix and provided her the amended report. Also at the facility was Licensee's husband/helper and 7 daycare children. Appropriate ratios and capacity were observed.

An exit interview was conducted with the Director. Copies of the amended report, this report (LIC809), appeal rights and Notice of Site Visit were provided. Notice of Site Visit (LIC9213) must remain posted for 30 days. LPA observed Notice of Site Visit being posted.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Keturah LaneTELEPHONE: (619) 767-2223
LICENSING EVALUATOR SIGNATURE:

DATE: 07/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021
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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