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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628981
Report Date: 01/03/2024
Date Signed: 01/03/2024 11:54:54 AM

Document Has Been Signed on 01/03/2024 11:54 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: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: 2DATE:
01/03/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Marie PierreTIME COMPLETED:
12:00 PM
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On 01/03/24 at 11:15AM, Licensing Program Analyst (LPA) Luigi Gargaro conducted an unannounced follow-up case management visit to the facility. The visit was conducted with the licensee so that analyst could speak to her about a 10/19/23 incident at the facility in which the same toddler who wandered away from the home on 10/26/23, left the day care on that same earlier date. Licensee provided analyst with the details of the incident during their interview.

Analyst reviewed and had licensee sign today’s visit report and provided her with a copy before he left the home. Licensee was also provided with a Notice of Site Visit that is to be posted for 30 days in the facility postings area.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2024
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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