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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374600641
Report Date: 01/28/2025
Date Signed: 01/28/2025 10:43:30 AM

Document Has Been Signed on 01/28/2025 10:43 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO RO, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:SPECIAL FRIENDS FOUNDATIONFACILITY NUMBER:
374600641
ADMINISTRATOR/
DIRECTOR:		WOJCIECHOWSKI, MICHELLEFACILITY TYPE:
735
ADDRESS:12461 VAUGHAN ROADTELEPHONE:
(858) 679-8213
CITY:POWAYSTATE: CAZIP CODE:
92064
CAPACITY: 6CENSUS: 6DATE:
01/28/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:05 AM
MET WITH:Administrator Michelle WojciechowskiTIME VISIT/
INSPECTION COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) Rebecca Borunda conducted an unannounced Collateral visit. LPA was greeted by, identified herself to, and discussed the purpose of the visit with Administrator Michelle Wojciechowski.

During today's visit, LPA reviewed and obtained copies of facility records related to a complaint investigation lodged against another facility licensed by Community Care Licensing.

An exit interview was conducted with Administrator Michelle Wojciechowski, whose signature below confirms receipt of a copy of this report and the Licensee Appeal Rights (LIC9058 3/22).
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Rebecca A Borunda
LICENSING EVALUATOR SIGNATURE: DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/28/2025
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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