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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701457
Report Date: 02/25/2020
Date Signed: 02/25/2020 11:21:07 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:GRACE KIDS PRESCHOOL NORTH PARK 2FACILITY NUMBER:
376701457
ADMINISTRATOR:LATERESA OROPEZAFACILITY TYPE:
850
ADDRESS:2930 HOWARD AVENUETELEPHONE:
(619) 741-3555
CITY:SAN DIEGOSTATE: CAZIP CODE:
92104
CAPACITY:75CENSUS: 0DATE:
02/25/2020
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Colleen TeranTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Yolanda Baez met with Program Director, Colleen Teran, at the San Diego Child Care Regional Office to comply with Component II orientation requirements.

The following documents were received during today's office meeting: Financial records, Corrections to LIC 200A, Corrections to LIC308, corrections to LIC 309, corrections to LIC 401, corrections LIC 500, corrections to the parent handbook and admission agreement, the addition of employee work hours and shifts and adding the abuse reporting procedures to the employee handbook. In addition the following was submitted for LaTeresa: Component 3 certificate, CPR/FA, 8 hour preventative health, immunization for measles, LIC 9108, LIC 508, and transfer request. The following was submitted for Nolan Lee: Component 1 and 3 orientation certificates and immunization record for Pertussis and Measles.

The following items are pending in order to complete the application: add who aide reports to in the Aide job description, please submit a current registry with the secretary of state for 2019, AB1207 for Nolan Lee and LaTeresa Oropeza (currently expired), Influenza vaccine or declaration for Nolan Lee, and LIC 9108 for Nolan Lee.

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

DATE: 02/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020
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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