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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604734
Report Date: 08/01/2024
Date Signed: 08/01/2024 04:40:42 PM

Document Has Been Signed on 08/01/2024 04:40 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:CHANGING OPTIONSFACILITY NUMBER:
374604734
ADMINISTRATOR/
DIRECTOR:		MELCHER, JENNIFERFACILITY TYPE:
735
ADDRESS:500 3RD STREETTELEPHONE:
(714) 224-0826
CITY:RAMONASTATE: CAZIP CODE:
92065
CAPACITY: 14CENSUS: 14DATE:
08/01/2024
TYPE OF VISIT:CollateralUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Program Manager Jennifer MelcherTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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Licensing Program Analyst (LPA) Juliana Barfield conducted an unannounced Collateral Visit. LPA was greeted by, identified themselves to, and discussed the purpose of the visit with Program Manager Jennifer Melcher.

During today’s visit, LPA conducted interviews to aid in an investigation occurring at another licensed care facility. No deficiencies were cited during this visit.

An exit interview was conducted with Program Manager Jennifer Melcher, to whom a copy of this report and the Licensee/Appeal Rights (LIC9058 03/22) were provided.

SUPERVISORS NAME: Lizzette Tellez
LICENSING EVALUATOR NAME: Juliana Barfield
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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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