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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628981
Report Date: 11/06/2023
Date Signed: 11/06/2023 12:41:48 PM

Document Has Been Signed on 11/06/2023 12:41 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:PIERRE, MARIE FAMILY CHILD CAREFACILITY NUMBER:
376628981
ADMINISTRATOR:MARIE PIERREFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 748-6410
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/06/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Marie PierreTIME COMPLETED:
12:45 PM
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At 10:35AM on 11/06/23, LPA Luigi Gargaro conducted an unannounced case management visit to the facility. Visit was conducted so that analyst could discuss a 10/26/23 incident in which a child in care wandered from the facility and was recovered at a neighborhood home.

Analyst met with the licensee and interviewed her regarding the details of the incident. Analyst also obtained family contact information for the child in question and other parties involved in the incident.

An exit interview was conducted and the report was reviewed with the licensee, Marie Pierre. A copy of this report, along with Appeal Rights (LIC9058 01/16), were provided. A notice of site visit was given and must remain posted for 30 days. LPA observed that the notice of site visit was posted during the inspection. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 11/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/06/2023
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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