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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603323
Report Date: 07/18/2024
Date Signed: 07/18/2024 12:31:55 PM


Document Has Been Signed on 07/18/2024 12:31 PM - 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:BARON'S PRESIDIO UNIVERSITY CITYFACILITY NUMBER:
374603323
ADMINISTRATOR:NARMINA MAMEDOVAFACILITY TYPE:
740
ADDRESS:6860 CONDON DRIVETELEPHONE:
(858) 558-4772
CITY:SAN DIEGOSTATE: CAZIP CODE:
92122
CAPACITY:6CENSUS: 5DATE:
07/18/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator Angie NortonTIME COMPLETED:
12:20 PM
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Licensing Program Analyst (LPA) Sabel Martinez conducted a case management visit to obtain signatures and deliver an amended report. LPA met with Administrator Angie Norton, introduced himself and disclosed the purpose of the visit.

Today's visit is to collect report signatures and deliver an amended report.

An exit interview was conducted with Norton, to whom a copy of the this report, and Appeal Rights (LIC 9058), were provided.
SUPERVISOR'S NAME: Lizzette TellezTELEPHONE: (619) -76-2351
LICENSING EVALUATOR NAME: Sabel MartinezTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:
DATE: 07/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/18/2024
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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