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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604613
Report Date: 03/12/2024
Date Signed: 03/12/2024 02:38:43 PM

Document Has Been Signed on 03/12/2024 02:38 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
CCLD Regional Office, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108
FACILITY NAME:OCEANSIDE IVEY RANCH PARK ASSOCIATIONFACILITY NUMBER:
374604613
ADMINISTRATOR:DANIELLY, TONYAFACILITY TYPE:
775
ADDRESS:110 RANCHO DEL ORO DRIVETELEPHONE:
(760) 722-4839
CITY:OCEANSIDESTATE: CAZIP CODE:
92057
CAPACITY: 12CENSUS: 9DATE:
03/12/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Administrator Tonya DaniellyTIME COMPLETED:
02:40 PM
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Licensing Program Analyst (LPA) Rebecca Ruiz conducted an unannounced case management visit to deliver an amended LIC809 report. LPA was greeted by and identified herself to, and explained the purpose of the visit to Staff Christina Paad. Administrator Tonya Danielly arrived during the visit.

During today’s visit, LPA obtained Tonya’s signature on the amended facility inspection reports dated 12/21/2023. As of today's visit, the Department has not provided the fire department with the correct forms to be able to update the facility's fire clearance.

An exit interview was conducted with Administrator Tonya Danielly, whose signature below confirms receipt of a copy of this report, the amended reports dated 12/21/2023, and the Licensee Appeal Rights (LIC9058 3/22).
SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Rebecca A Ruiz
LICENSING EVALUATOR SIGNATURE: DATE: 03/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/12/2024
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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