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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376613972
Report Date: 03/10/2020
Date Signed: 03/10/2020 12:43:16 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MAYER, TERESA FAMILY CHILD CAREFACILITY NUMBER:
376613972
ADMINISTRATOR:MAYER, TERESAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 419-0166
CITY:OCEANSIDESTATE: CAZIP CODE:
92056
CAPACITY:14CENSUS: 5DATE:
03/10/2020
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:06 PM
MET WITH:Teresa MayerTIME COMPLETED:
12:53 PM
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Licensing Program Analyst (LPA) Otsanya Cameron, conducted a Plan of Correction (POC) visit to clear deficiencies cited on 03/02/20. Licensee has installed a lock on the drawer where her Knives are stored in order to make them inaccessible to children in care. Licensee has the keys located in the kitchen. Licensee and LPA discussed assessing the risk, development and ages of children in care to determine location of keys.

AN EXIT INTERVIEW WAS CONDUCTED. A copy of this report was provided to the licensee on this date and must be made available to the public upon request for the next 3 years.
SUPERVISOR'S NAME: Dawn ParkerTELEPHONE: (951) 320-2101
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:

DATE: 03/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2020
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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