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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604296
Report Date: 03/14/2024
Date Signed: 03/14/2024 12:42:57 PM

Document Has Been Signed on 03/14/2024 12:42 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:DAWN BRIGHT HOUSEFACILITY NUMBER:
374604296
ADMINISTRATOR:BRIGHT, DAWNFACILITY TYPE:
735
ADDRESS:680 SEACOAST DRIVETELEPHONE:
(619) 207-0335
CITY:IMPERIAL BEACHSTATE: CAZIP CODE:
91932
CAPACITY: 4CENSUS: 4DATE:
03/14/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Dawn Bright, LicenseeTIME COMPLETED:
12:40 PM
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Licensing Program Analyst (LPA) Carmen Lopez conducted an unannounced required annual inspection and in conjunction conducted this case management visit at the facility. LPA Lopez identified herself and was granted entry by Rocky Humphreys, Direct Services Provider. LPA stated the purpose of the visit and reviewed the basic elements of the case management visit with Licensee Dawn Bright.

During today’s visit, LPA provided the Licensee consultation and provided additional information regarding the Department’s website, and Criminal Background Clearance Transfer Request (LIC9182) and Criminal Record Exemption Transfer Request (LIC 9188) Form Updates (PIN 23-08-CCLD).

No deficiencies were observed or cited during the visit. An exit interview was conducted with Licensee Dawn Bright and a copy of this report, and Licensee/Appeal Rights (LIC 9058 3/22) were provided to the Licensee at the conclusion of the visit. The signature below confirms the documents were received.
SUPERVISORS NAME: Jennifer Lott
LICENSING EVALUATOR NAME: Carmen Lopez
LICENSING EVALUATOR SIGNATURE: DATE: 03/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/14/2024
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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