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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376616522
Report Date: 06/27/2024
Date Signed: 06/27/2024 03:52:28 PM

Document Has Been Signed on 06/27/2024 03:52 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 NORTH, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CHRISTENSEN, THERESA & JAROD FAMILY CHILD CAREFACILITY NUMBER:
376616522
ADMINISTRATOR/
DIRECTOR:		THERESA & JAROD C.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 334-0797
CITY:EL CAJONSTATE: CAZIP CODE:
92019
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Jarod ChristensenTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On June 27, 2024, at 3:30 PM Licensing Program Analyst (LPA) Sherlynn Banas conducted an unannounced Case Management inspection for the purpose of providing an Amended report originally provided on 06/12/2024. At arrival LPA met with licensee, Jarod Christensen. No children were present at the time of inspection.

Exit interview conducted and report was reviewed with the licensee, Jarod Christensen. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Sherlynn Banas
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2024
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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