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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604232
Report Date: 02/13/2025
Date Signed: 02/13/2025 04:17:24 PM

Document Has Been Signed on 02/13/2025 04:17 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:REMINGTON CLUB IIFACILITY NUMBER:
374604232
ADMINISTRATOR/
DIRECTOR:		TERRI BOSTIANFACILITY TYPE:
740
ADDRESS:16922 HIERBA DRIVETELEPHONE:
(858) 673-6333
CITY:SAN DIEGOSTATE: CAZIP CODE:
92128
CAPACITY: 140TOTAL ENROLLED CHILDREN: 0CENSUS: 50DATE:
02/13/2025
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:35 PM
MET WITH:Raquel Mathews, Director of Health and WellnessTIME VISIT/
INSPECTION COMPLETED:
04:20 PM
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Licensing Program Analyst’s (LPAs) Carmen Lopez and Arian Golbakhsh conducted an unannounced collateral visit to the facility. LPAs Lopez and Golbakhsh identified themselves and were granted entry by Sabrina Uchino, Resident Services Associate. LPAs stated the purpose of the visit with Raquel Mathews, Director of Health and Wellness.

During the visit, LPAs Lopez and Golbakhsh spoke with staff to aid in an open investigation involving a different unlicensed care facility. No deficiencies were observed or cited during today's visit.

An exit interview was conducted, and a copy of this report along with Licensee/Appeal Rights (LIC9058 03/22) were provided to Raquel Mathews, Director of Health and Wellness, at the conclusion of the visit. The signature below confirms the receipt of the documents.
Robyn ClarkTELEPHONE: (619) 767-2312
Carmen LopezTELEPHONE: (619) 767-2301
DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/13/2025
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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