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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629259
Report Date: 05/01/2023
Date Signed: 05/01/2023 11:12:15 AM

Document Has Been Signed on 05/01/2023 11:12 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:TACHIQUIN, PATRICIA FAMILY CHILD CARE HOMEFACILITY NUMBER:
376629259
ADMINISTRATOR:PATRICIA TACHIQUINFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 203-2309
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 6CENSUS: DATE:
05/01/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Patricia TachiquinTIME COMPLETED:
11:15 AM
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On 05/01/23 at 10:40AM, Licensing Program Analyst (LPA) Luigi Gargaro conducted an unannounced case management visit with licensee Patricia Tachiquin. The visit was conducted to issue an immediate civil penalty for a 04/04/23 substantiated lack of supervision complaint finding.

Analyst reviewed today's report with the licensee, Patricia Tachiquin, and had her sign for it and the corresponding manual Civil Penalty Assessment Form (LIC 421IM). Ms. Tachiquin was also provided a copy of her appeal rights for the civil penalty and a notice of site visit that must remain posted for 30 days. 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: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/01/2023
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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