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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628484
Report Date: 08/04/2022
Date Signed: 08/04/2022 12:47:12 PM

Document Has Been Signed on 08/04/2022 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:BEILESON, ELSA & OSCAR FAMILY CHILD CAREFACILITY NUMBER:
376628484
ADMINISTRATOR:ELSA & OSCAR B.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 608-7140
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
08/04/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Elsa Beileson, ProviderTIME COMPLETED:
12:50 PM
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Licensing Program Analyst (LPA) D. Sanchez, made an unannounced follow up Case Management inspection to the facility today in response to an Unusual Incident/Injury Report received via voice mail on 7/02/2022, and subsequently sent written report to the San Diego Child Care Regional Office (SDCCRO) on 7/11/2022. Report states that on 6/25/2022, provider called 911 due to provider being in pain and taken to UCSD hospital.

LPA interviewed provider and reviewed incident report during today's inspection. Provider stated that she initially sent report via email to LPA on 7/27/2022, but didn't realize report was not sent. Therefore, on 7/11/2022, she re-sent report to LPA Sanchez via text message.

LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

Community Care Licensing WEB SITE: http://www.ccld.ca.gov

An exit interview was conducted with Elsa Beileson and a copy of this report left at the facility.

LPA observed provider placing the Notice of Cite Visit on the wall visible to parents during today’s inspection.

NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Diana Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 08/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/04/2022
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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