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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374604768
Report Date: 08/06/2024
Date Signed: 08/06/2024 03:55:15 PM


Document Has Been Signed on 08/06/2024 03:55 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
SO. CAL AC/SC, 7575 METROPOLITAN DR. #109
SAN DIEGO, CA 92108



FACILITY NAME:IVY PARK AT LA JOLLAFACILITY NUMBER:
374604768
ADMINISTRATOR:FRANZ, MEGANFACILITY TYPE:
740
ADDRESS:810 TURQUOISE STREETTELEPHONE:
(858) 488-4300
CITY:SAN DIEGOSTATE: CAZIP CODE:
92109
CAPACITY:76CENSUS: 53DATE:
08/06/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Megan Franz, AdministratorTIME COMPLETED:
04:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Daniel Pena attempted to conduct an announced Pre-Licensing inspection, Component III presentation, and to observe the facility’s physical plant for compliance with Title 22, Division 6 of the California Code of Regulations and California Health & Safety Code. LPA was greeted at the front entrance by the Applicant/Administrator, Megan Franz and was granted entry after identifying himself and disclosing the purpose of the visit.

The facility is undergoing a change of ownership. During the inspection, LPA reviewed the application with Applicant/Administrator, Franz. Upon examination, the fire clearance was approved on 05/06/2024, however it was determined that further evaluation by the fire inspector and Centralized Application Bureau is needed in order to complete the pre licensing inspection.

An exit interview was conducted with Applicant/Administrator Franz, to whom a copy of this report along with the licensee Appeal Rights (LIC 9058 01/16) were provided at the conclusion of the visit. The signature below confirms receipt of these documents.
SUPERVISOR'S NAME: Simon JacobTELEPHONE: (619) 767-2306
LICENSING EVALUATOR NAME: Daniel PenaTELEPHONE: (619) 767-2301
LICENSING EVALUATOR SIGNATURE:
DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2024
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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