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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628244
Report Date: 12/02/2021
Date Signed: 12/02/2021 10:08:22 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:MONTALVO, MARINA FAMILY CHILD CAREFACILITY NUMBER:
376628244
ADMINISTRATOR:MARINA MONTALVOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 279-4015
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY:14CENSUS: 10DATE:
12/02/2021
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Carolina ToscanoTIME COMPLETED:
10:15 AM
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On 12/2/21 at 9:00 am Licensing Program Analysts (LPAs) Gloria Gonzalez and David Miller conducted an unnanounced case management to interview a daycare child unrelated to this facility. LPAs met with Assistant Carolina Toscano and Toscano granted entrance into the home. At the time of this visit there were 10 daycare children and another assistant, Cynthia Rodriguez. Facility is within ratio and capacity.

This report was translated in Spanish by LPA Gonzalez.

An exit interview was conducted. A copy of this report along with notice of site visit was provided.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Gloria GonzalezTELEPHONE: (619) 767-2238
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2021
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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