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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376610523
Report Date: 08/14/2020
Date Signed: 08/14/2020 10:40:32 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:SORIANO, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376610523
ADMINISTRATOR:SORIANO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 534-3458
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:14CENSUS: 3DATE:
08/14/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:59 AM
MET WITH:Maria Soriano, LicenseeTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA), Michelle Hood, made an unannounced tele-inspection to follow-up on an operational status of facility. At the time of inspection, there were three children in care with licensee and helper. The facility is within licensed capacity/ratio limitations. LPA conducted interviews with licensee and helper.

Licensee stated there are no new adults living in the home over the age of 18 years.
The home was toured and inspected to ensure environment is safe for the care and supervision of children.

An exit interview was conducted. This report will be emailed to the licensee and their reply acknowledges receipt of this report. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA emailed Licensee a copy of the notice of site visit. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov

No Deficiencies were cited today.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (619) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2020
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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