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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701426
Report Date: 11/01/2022
Date Signed: 11/01/2022 07:54:11 PM


Document Has Been Signed on 11/01/2022 07:54 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:OPENMINDS ADAMS ELEMENTARYFACILITY NUMBER:
376701426
ADMINISTRATOR:JUDITH DRAPKINFACILITY TYPE:
840
ADDRESS:4672 35TH STREETTELEPHONE:
(619) 665-1264
CITY:SAN DIEGOSTATE: CAZIP CODE:
92116
CAPACITY:30CENSUS: 13DATE:
11/01/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Christine DamicoTIME COMPLETED:
05:15 PM
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On 11/1/22 at 3:15pm Licensing Program Analyst (LPA), Martha Malane conducted an unannounced case management inspection to follow up on a self-reported unusual incident. Upon arrival, LPA met with staff member, Michelle Tirpak. At 3:30pm 13 children and Owner, Christine Damico arrived at the facility.

An unusual incident report (UIR) was submitted to the San Diego Regional Office (SDRO) 10/21/22 alleging a possible personal rights violation that occurred on 10/20/22. Records were reviewed and interviews conducted with staff and children in care. Based on the information obtained the incident requires further review.

No deficiencies cited.

Exit interview conducted with Owner, Christine Damico.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:
DATE: 11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/01/2022
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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