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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376601494
Report Date: 12/09/2024
Date Signed: 12/09/2024 12:47:57 PM

Document Has Been Signed on 12/09/2024 12:47 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 CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:RUIZ, ANA LAURA FAMILY CHILD CAREFACILITY NUMBER:
376601494
ADMINISTRATOR/
DIRECTOR:		RUIZ, ANA LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 690-0480
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
12/09/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:45 AM
MET WITH:Licensee, Ana Laura RuizTIME VISIT/
INSPECTION COMPLETED:
12:50 PM
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On 12/9/2024 at 10:45 am, LPA Shannan WIlliams conducted a Case Management inspection. The purpose of the inspection is to deliver an amended reports. Please see LIC9099 dated 10/21/2024 and LIC809 and LIC809D pages dated 10/21/2024. LPA met with Licensee, Ana Laura Ruiz, and discussed the purpose of the inspection.

This LIC809 will be used to memorialize the delivering of the amended report.

LPA assessed observed and reviewed documents to clear POC's in place for deficiencies previously cited.

No citations issued on this date.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Shannan Williams
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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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