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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701002
Report Date: 06/06/2019
Date Signed: 06/06/2019 03:56:08 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: 21DATE:
06/06/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Jamie PorterTIME COMPLETED:
04:00 PM
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On this date and time, Licensing Program Analyst (LPA) Laura Callahan 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.

LPA conducted a prior visit to the facility on 05/29/19 in regards to this incident. During the visit, LPA reviewed facility records and conducted interviews. On this date, additional interviews were conducted.

The subject child was not present on either visit. 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: 06/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2019
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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