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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701138
Report Date: 02/01/2023
Date Signed: 02/01/2023 12:38:47 PM

Document Has Been Signed on 02/01/2023 12:38 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:DOT TO DOTFACILITY NUMBER:
376701138
ADMINISTRATOR:ADRIANA RIVERAFACILITY TYPE:
850
ADDRESS:12160 ALTA CARMEL COURTTELEPHONE:
(858) 485-1978
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY: 56TOTAL ENROLLED CHILDREN: 47CENSUS: 42DATE:
02/01/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Cassandra Goldstein/New DirectorTIME COMPLETED:
12:45 PM
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On 2/01/2023 at 10:30am, Licensing Program Analyst (LPA) Selina Siao conducted a plan of correction inspection to ensure that the facility is in substantial compliance. Upon arrival, LPA met with New Director Cassandra Goldstein and conducted a tour of the facility inside and outside. Facility is within staffing ratio during the inspection and all staff members has the required background clearances and are associated to the facility.

The monkey bar and wall climber are not accessible to children. No hazardous are accessible to children at the facility. The snack menu is posted at the facility.

LPA provided facility with citation clearances letters today and there are a few pending corrections that will be submitted to LPA upon completion.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Selina Siao
LICENSING EVALUATOR SIGNATURE: DATE: 02/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/01/2023
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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