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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701453
Report Date: 12/10/2019
Date Signed: 12/10/2019 10:13:38 AM

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:KIDS ON THE GOFACILITY NUMBER:
376701453
ADMINISTRATOR:LYNN TWORKFACILITY TYPE:
850
ADDRESS:2015 BIRCH ROAD #210TELEPHONE:
(619) 519-1957
CITY:CHULA VISTASTATE: CAZIP CODE:
91915
CAPACITY:192CENSUS: 0DATE:
12/10/2019
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Lynn and Christopher TworkTIME COMPLETED:
10:30 AM
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Licensing Program Analyst (LPA) Yolanda Baez met with Christopher Twork and Applicant Lynn Twork at the San Diego Child Care Regional Office to comply with Component II orientation requirements.

The Notice of Incomplete Application (NOI) dated 12/06/2019 was provided to Applicant and reviewed. During today's office meeting, Applicant provided all of the pending documents listed on the NOI except for the Incidental Medical Services (IMS) Plan of Operation. Applicant stated that she will submit the IMS Plan of Operation via email as soon as possible as well as the last 3 months of bank statements for November 2019, October 2019, and September 2019.

Pre-licensing inspection is scheduled for Thursday, 12/12/2019 at 9:30am.

SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019
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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