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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600372
Report Date: 10/30/2020
Date Signed: 10/30/2020 12:20:21 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. #109
SAN DIEGO, CA 92108
FACILITY NAME:CLOISTERS OF THE VALLEY, LLCFACILITY NUMBER:
374600372
ADMINISTRATOR:CHANNA KELLYFACILITY TYPE:
740
ADDRESS:4171 CAMINO DEL RIO SOUTHTELEPHONE:
(619) 283-2226
CITY:SAN DIEGOSTATE: CAZIP CODE:
92108
CAPACITY:0CENSUS: 0DATE:
10/30/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Catherine Tovar, Business Office DirectorTIME COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Daniel Pena conducted a Case Management visit to deliver an amended report for a visit conducted on 04/20/2020. LPA Pena met with Business Office Director, Catherine Tovar via FaceTime, due to Covid-19, and informed her of the purpose of the visit.

During today’s virtual visit, LPA delivered an amended LIC9099 Complaint Investigation Report dated 10/30/2020 via email.

An exit interview was conducted and a copy of this report and LIC9058 Licensee Appeal/Rights was provided to Director Tovar via email. An email read receipt confirms receipt of these documents.
SUPERVISOR'S NAME: John RanteTELEPHONE: (619) 994-7269
LICENSING EVALUATOR NAME: Daniel PenaTELEPHONE: (619) 994-7269
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2020
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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