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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701002
Report Date: 05/29/2019
Date Signed: 05/29/2019 02:08:57 PM

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 INC.- SCHOOL AGEFACILITY NUMBER:
376701002
ADMINISTRATOR:JAMIE PORTERFACILITY TYPE:
840
ADDRESS:986 W EL NORTE PKWYTELEPHONE:
(760) 480-1300
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY:30CENSUS: 10DATE:
05/29/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:17 PM
MET WITH:Jamie PorterTIME COMPLETED:
02:10 PM
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On this date and time, Licensing Program Analysts (LPAs) Laura Callahan and Sharleen Robinson met with Director Jamie Porter, toured the facility and took census.

A case management visit is being conducted in response to the receipt of an unusual incident report (UIR) from the facility. The UIR was received by the licensing agency on 05/20/19.

Facility records were reviewed and interviews were conducted. Further information will be needed. Upon completion of the review, the outcome and/or recommendations will be provided to the licensee.

An exit interview was conducted and a copy of this report was provided to facility staff.
SUPERVISOR'S NAME: Kimberly WilliamsTELEPHONE: (951) 248-0228
LICENSING EVALUATOR NAME: Laura CallahanTELEPHONE: (951) 204-4913
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019
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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