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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376602479
Report Date: 04/12/2022
Date Signed: 04/12/2022 01:39:15 PM

Document Has Been Signed on 04/12/2022 01:39 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 STE 110
SAN DIEGO, CA 92108
FACILITY NAME:SALVADOR, ARIEL & ANITA FAMILY CHILD CAREFACILITY NUMBER:
376602479
ADMINISTRATOR:ARIEL & ANITA S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 467-9821
CITY:SAN DIEGOSTATE: CAZIP CODE:
92123
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
04/12/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Anita Salvador, LicenseeTIME COMPLETED:
12:50 PM
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On 04/12/2022 at 12:20 pm., Licensing Program Analysts (LPAs), Michelle Hood and Cindy Meier conducted an unannounced case management Inspection and met with the Licensee Anita Salvador. LPAs disclosed the purpose of the inspection. There were 11 children present in the facility during this inspection. LPAs interview two daycare children.

An exit interview was conducted and the report was reviewed with the licensee Anita Salvador. The licensee will be e-mailed a copy of their licensing report, appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. A notice of site visit was e-mailed and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies cited.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/12/2022
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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