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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626534
Report Date: 10/16/2019
Date Signed: 10/16/2019 01:01:18 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
FACILITY NAME:PACKER,GREDNA FAMILY CHILD CAREFACILITY NUMBER:
376626534
ADMINISTRATOR:GREDNA PACKERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 229-2035
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY:14CENSUS: 4DATE:
10/16/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:21 PM
MET WITH:Gredna PackerTIME COMPLETED:
01:10 PM
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Licensing Program Analysts (LPAs) Selina Siao and Tyra Block conducted a plan of correction inspection to ensure that the facility is in compliance with Licensing rules and regulations. Present at the facility today is licensee and four day care children including two infants and two children that are two years old.

The following corrections have been cleared:

· Facility is within staffing ratio during today’s inspection.
· Licensee provided a copy of her helper’s Patricia Escamilla’s TB clearances.
· Licensee provided a copy of her helper Patricia Escamilla’s required immunizations.


Facility is within substantial compliance during today’s inspection.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Selina SiaoTELEPHONE: (619) 767-2217
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2019
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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