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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374603533
Report Date: 09/01/2023
Date Signed: 09/05/2023 10:23:00 AM

Document Has Been Signed on 09/05/2023 10:23 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:WORK SKILL RESOURCESFACILITY NUMBER:
374603533
ADMINISTRATOR:ENUNWA, EBELEFACILITY TYPE:
775
ADDRESS:9349 JAMACHA BLVDTELEPHONE:
(619) 512-1107
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 60CENSUS: 57DATE:
09/01/2023
TYPE OF VISIT:CollateralUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Administrator Ebele Enunwa and Assistant Administrator Tracy McKnightTIME COMPLETED:
01:00 PM
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Licensing Program Manager (LPM) Simon Jacob and San Diego Regional Center Service Coordinator Evan Sterk conducted an unannounced collateral visit to conduct interviews unrelated to the facility. LPM was granted entry and met with Administrator Ebele Enunwa and Assistant Administrator Tracy McKnight. LPM and SDRC Service Coordinator conducted joint interviews with clients who reside at an Adult Residential Facility licensed by the Department.

No deficiencies were cited or observed on this date.

The Licensee was provided a copy of their appeal rights (LIC9058 01/16). An exit interview was conducted and a copy of this report was provided to Administrator Ebele Enunwa.
SUPERVISORS NAME: Kimberly Lyon
LICENSING EVALUATOR NAME: Simon Jacob
LICENSING EVALUATOR SIGNATURE: DATE: 09/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2023
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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