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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376600901
Report Date: 11/17/2023
Date Signed: 11/17/2023 11:04:21 AM


Document Has Been Signed on 11/17/2023 11:04 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:FAMILY RECOVERY CENTER - CHILD DEV. CENTERFACILITY NUMBER:
376600901
ADMINISTRATOR:MELISSA GREENWAYFACILITY TYPE:
850
ADDRESS:1100 SPORTFISHER DRIVETELEPHONE:
(760) 227-1345
CITY:OCEANSIDESTATE: CAZIP CODE:
92054
CAPACITY:12CENSUS: 0DATE:
11/17/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Fabiola BellingerTIME COMPLETED:
10:35 AM
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On date and time listed above, Licnesing Program Analyst (LPA) Keely Messerschmidt arrived at the facility to conduct an unannounced Annual visit. LPA met with Program Manager Fabiola Bellinger and informed her the reason for todays visit.

Program Manager informed LPA that they wanted to have their facility move to Inactive Status due to low enrollment and the Director no longer working for the company. LPA obtained the LIC9211 Inactive Status form during visit.

A Notice of Site Visit was provided and must remain posted for 30 days. An exit interview was conducted, and a copy of this report was provided to the Program Director.
SUPERVISOR'S NAME: Deborah MullenTELEPHONE: (951) 505-6334
LICENSING EVALUATOR NAME: Keely MesserschmidtTELEPHONE: (951) 781-4200
LICENSING EVALUATOR SIGNATURE:
DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/17/2023
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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