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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376601951
Report Date: 04/21/2022
Date Signed: 04/21/2022 11:56:34 AM

Document Has Been Signed on 04/21/2022 11:56 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:JONES, BRENDA FAMILY DAY CAREFACILITY NUMBER:
376601951
ADMINISTRATOR:BRENDA JONESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 847-6980
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/21/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Brenda Jones, LiceseeTIME COMPLETED:
12:10 PM
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On 04/21/2022 at 11:10 am., Licensing Program Analyst (LPA), Michelle Hood attempted to conducted an unannounced Annual Required Inspection and met with the Licensee Brenda Jones. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. The licensee stated she is not caring for daycare children at this time. There were no daycare children present in the facility during this inspection. The licensee requested for an inactive status. The licensee completed the Request for Inactive Child Care License Status- LIC 9211 form, requesting her license be placed on inactive status 04/21/2022 to 06/05/2022.

An exit interview was conducted and the report was reviewed with the licensee Brenda Jones. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies cited.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2022
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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