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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600310
Report Date: 06/19/2023
Date Signed: 07/13/2023 04:48:30 PM


Document Has Been Signed on 07/13/2023 04:48 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 07/11/2023 04:18 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

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***This is an amended version of an original report created on 06/19/2023 .

On June 19th at 09:31 AM, Licensing Program Analyst (LPA) David Miller conducted a case management inspection to follow-up on a self reported incident of a possible personal rights violation. LPA advised the Assistant Director, Liliana Arredondo of the inspection’s purpose and was granted facility entry. Assistant Director, Liliana Arredondo, LPA with a facility tour.

During the tour of the facility, there were ten (10) children and two (2) staff in the 2-year old class, seven (7) children and two (2) staff in the 3-year old class, twelve (12) children and two (2) staff in the 4-year old classroom, and twelve (12) children and one (1) staff in the 5-year old classroom.



During this inspection, LPA interviewed the Director, staff, and the staff involved in the alleged incident. All staff stated that no childrens' personal rights were ever violated. The child in question no longer attends the daycare. No deficiencies cited.

Staff was provided with A Notice of Site Visit (LIC 9213), which is to be posted for thirty (30) days. An exit interview was conducted with the Assistant Director, Liliana Arredondo. Licensee/Appeal Rights (LIC 9098) along with a copy of this report was provided to Assistant Director, Liliana Arredondo and their signature on this form confirms receipt of these rights.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: David MillerTELEPHONE: (619) 987-8901
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2023
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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