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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701499
Report Date: 09/30/2021
Date Signed: 09/30/2021 01:02:01 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:CHILDREN'S CHOICE ACADEMY, INC.FACILITY NUMBER:
376701499
ADMINISTRATOR:JENNI GRAWVUNDERFACILITY TYPE:
830
ADDRESS:73 NORTH SECOND AVENUETELEPHONE:
(619) 249-4328
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:32CENSUS: 0DATE:
09/30/2021
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
11:31 AM
MET WITH:Jennifer House TIME COMPLETED:
12:00 PM
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On 09/30/21 at 11:31 a.m. Licensing Program Analyst (LPA), Rajani Goudreau met with applicant representatives: President, Jennifer House, and VP of Operations, Jennifer Grawvunder. The purpose of today's meeting is to review the pending documents listed on the LIC184 - Notice of Incomplete Application Checklist.

LPA reviewed the pending documents with applicant representatives. The following items remain pending on the application: Fire Clearance and a valid Pediatric CPR/First Aid Certificate for the director or a staff member that will be on site full time. LPA discussed the pending documents in detail with the licensee representatives. Applicant representatives acknowledge understanding of the pending documents.

A copy of this report was reviewed and provided during today's visit.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Rajani GoudreauTELEPHONE: (619) 767-2215
LICENSING EVALUATOR SIGNATURE:

DATE: 09/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2021
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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