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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701257
Report Date: 01/08/2020
Date Signed: 01/08/2020 02:52:50 PM

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:KID VENTURESFACILITY NUMBER:
376701257
ADMINISTRATOR:KAREN NILSSONFACILITY TYPE:
850
ADDRESS:10760 THORNMINT ROADTELEPHONE:
(858) 207-6088
CITY:SAN DIEGOSTATE: CAZIP CODE:
92127
CAPACITY:15CENSUS: 10DATE:
01/08/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:21 PM
MET WITH:Melissa Overland Mckay TIME COMPLETED:
03:00 PM
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Licensing Program Analyst (LPA), Rajani Goudreau conducted an unannounced case management visit for the purpose of delivering an amended report originally created on 01/07/20. Upon arrival, LPA met with Director, Melissa Overland Mckay and proceeded to tour the facility. LPA verified facility was within proper ratio and capacity limitations. LPA discussed Directors packet with Director. At this time, the Department has not received a Directors packet for the above Director.

No deficiencies issued throughout today's inspection. LPA reviewed this report with Director and an exit interview was conducted. LPA informed Director Notice of Site Visit - LIC 9213 must be posted for 30 days from today's date. LPA observed Director post notice of site visit. Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 01/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2020
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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