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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603444
Report Date: 07/08/2024
Date Signed: 07/08/2024 04:11:14 PM


Document Has Been Signed on 07/08/2024 04:11 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:OPALEC BOARD AND CAREFACILITY NUMBER:
374603444
ADMINISTRATOR:LEANN COX OPALECFACILITY TYPE:
740
ADDRESS:5638 PLUMAS STREETTELEPHONE:
(619) 434-6366
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:6CENSUS: 6DATE:
07/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Care giver Carlido Miranda TIME COMPLETED:
02:45 PM
NARRATIVE
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Licensing Program Analyst (LPA) Amy Rodgers conducted an unannounced visit to discuss the delivery of the plan of correction. LPA identified herself, was granted entry, and stated the purpose of the visit to confirm a plan of correction issued on 6/4/2024, with Care giver Carlido Miranda
 
LPA conducted a welfare check as well as a phone call to the licensee and an email to the administrator. Plan of Correction that was issued on 6/4/2024 was extended to 7/18/2024.

An exit interview was conducted with Care giver Carlido Miranda. A copy of this report and Licensee Appeal Rights (9058 03/22) were provided to Administrator after the conclusion of the visit,
SUPERVISOR'S NAME: Denise PowellTELEPHONE: (619) 767-2317
LICENSING EVALUATOR NAME: Amy RodgersTELEPHONE: 619-997-4108
LICENSING EVALUATOR SIGNATURE:
DATE: 07/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/08/2024
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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