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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627129
Report Date: 11/08/2019
Date Signed: 11/08/2019 12:44:01 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:PALMA, LIZBETH FAMILY CHILD CAREFACILITY NUMBER:
376627129
ADMINISTRATOR:LIZBETH PALMAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 929-4003
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY:14CENSUS: 11DATE:
11/08/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Lizbeth PalmaTIME COMPLETED:
12:45 PM
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LPA Adrian Castellon conducted a case management inspection on this date. LPA Castellon met with licensee Palma. Licensee recently advised the SDCCRO that the facility has purchased a firearm.

LPA Castellon toured the facility on this date. LPA Castellon reviewed and discussed licensing regulations.

Firearm is properly secured and stored via licensing regulations.

No citations issued on this date.
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
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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