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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376617485
Report Date: 04/26/2023
Date Signed: 04/26/2023 08:55:40 AM

Document Has Been Signed on 04/26/2023 08:55 AM - 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:ACOSTA, ALMA FAMILY CHILD CAREFACILITY NUMBER:
376617485
ADMINISTRATOR:ALMA ACOSTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 280-1515
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
04/26/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:46 AM
MET WITH:Alma Acosta TIME COMPLETED:
09:10 AM
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On 04/26/23 at 8:13 AM Licensing Program Analyst (LPA) Annette Sutherland arrived at facility for the purpose of delivering an amended report. LPA toured facility with Licensee Alma Acosta also present was licensee's husband Jesus Hernandez and 1 day care child.

LPA provided notice of site visit, Appeal rights. No deficiencies were cited.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2023
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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