<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701420
Report Date: 06/29/2021
Date Signed: 06/29/2021 09:03:10 AM

Document Has Been Signed on 06/29/2021 09:03 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:YOUNG ANGELS CENTERFACILITY NUMBER:
376701420
ADMINISTRATOR:LARIZA PETERSONFACILITY TYPE:
840
ADDRESS:260 FIFTH AVENUETELEPHONE:
(619) 851-6828
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 30TOTAL ENROLLED CHILDREN: 0CENSUS: 10DATE:
06/29/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:38 AM
MET WITH:Lariza Peterson TIME COMPLETED:
09:10 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 06/29/21 at 8:38 a.m., Licensing Program Analyst (LPA), Rajani Goudreau, made a unannounced Case Management inspection to deliver an amended report originally created on 06/22/21 and to review the children's restroom to ensure there is sufficient toilets and sinks for the capacity increase. Upon visit, LPA met with director Lariza Peterson and proceeded to tour the facility. During the inspection there were 10 children in care with two staff members present.
 
LPA observed two toilets and two sinks in the boys restroom and two toilets and two sinks in the girls restroom. There is sufficient toilets and sinks to accommodate the requested capacity of 43 school age children. Both of the restrooms provide toilet privacy for the school age children in care. The restrooms are in safe and sanitary operating condition.

No deficiencies issued during today's inspection. An exit interview was conducted. The following was discussed and provided: LIC809, LIC809 amendment originally created on 06/22/21, Appeal Rights (LIC9058), and the Notice of Site Visit (LIC9058). The Notice of Site Visit shall be posted for 30 days from today's date.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Rajani Goudreau
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1