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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626769
Report Date: 10/17/2022
Date Signed: 10/17/2022 12:24:20 PM


Document Has Been Signed on 10/17/2022 12:24 PM - It Cannot Be Edited

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:GODINEZ, SAYRA FAMILY CHILD CAREFACILITY NUMBER:
376626769
ADMINISTRATOR:SAYRA GODINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 864-3880
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:14CENSUS: 0DATE:
10/17/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Sayra GodinezTIME COMPLETED:
12:29 PM
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On 10/17/2022 Licensing Program Analyst (LPA) Edgar Campana, met with Licensee, Sayra Godinez to deliver findings for complaint number 20-CC-20220915083517. Meeting was held at the San Diego Regional Child Care office as Licensee surrendered license on 09/23/2022 and is no longer operating at licensed facility address.

Exit interview was conducted and a copy of this report was given to Licensee, Sayra Godinez.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Edgar CampanaTELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:
DATE: 10/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/17/2022
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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