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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700121
Report Date: 09/23/2021
Date Signed: 09/23/2021 10:13:23 AM

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:CHILDREN'S PARADISE-MELROSE INFANTFACILITY NUMBER:
376700121
ADMINISTRATOR:CHRISTINA JENKINSFACILITY TYPE:
830
ADDRESS:145 N. MELROSE DR. STE 100TELEPHONE:
(760) 724-5600
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY:32CENSUS: 19DATE:
09/23/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Christina JenkinsTIME COMPLETED:
10:30 AM
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On this date, Licensing Program Analyst (LPA) Alaina Wilburn conducted a case management inspection and delivered amended reports that were initially provided to the facility on September 1, 2021. LPA Wilburn toured the facility and the following was observed:

Appropriate use of face coverings by staff was observed. A good faith effort to encourage children to wear face coverings appropriately was observed.

No deficiencies were cited on this date. An exit interview was conducted, a Notice of Site Visit (LIC 9213) was posted, appeal rights were discussed and provided, and a copy of this report was given to the facility representative below.
SUPERVISOR'S NAME: Stephanie HudakTELEPHONE: (951) 320-2021
LICENSING EVALUATOR NAME: Alaina WilburnTELEPHONE: (951) 255-9024
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
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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