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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376700828
Report Date: 05/12/2022
Date Signed: 05/12/2022 12:09:01 PM


Document Has Been Signed on 05/12/2022 12:09 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:DISCOVERY ISLE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
376700828
ADMINISTRATOR:GRIGGS, ASHLEYFACILITY TYPE:
850
ADDRESS:3791 OCEANIC WAYTELEPHONE:
(760) 433-3911
CITY:OCEANSIDESTATE: CAZIP CODE:
92056
CAPACITY:130CENSUS: 66DATE:
05/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:03 AM
MET WITH: Facility Representative- Giuliana GiardinoTIME COMPLETED:
12:18 PM
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Licensing Program Analyst (LPA) Otsanya Cameron arrived at the facility to conduct a Case Management visit to follow-up on an Unusual Incident report submitted to the Department. The incident occurred on 4/29/22, and was submitted by the facility within reporting period. LPA Cameron took census and toured facility. LPA interviewed Staff and reviewed facility records.

An immediate informal discussion was held with all staff involved and a scheduled (Mandatory) Professional Development day training on Personal rights will be held on 6/30/22 with all staff.

No Deficiencies cited.

An exit interview was held with Facility Representative Guiliana Giardino A Notice of Site visit was issued, along with a copy of this report.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Otsanya CameronTELEPHONE: (951) 970-1388
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2022
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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