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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627287
Report Date: 07/28/2022
Date Signed: 07/28/2022 03:48:01 PM

Document Has Been Signed on 07/28/2022 03:48 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:SOMMERVILLE, JESSICA FAMILY CHILD CAREFACILITY NUMBER:
376627287
ADMINISTRATOR:JESSICA SOMMERVILLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 592-3935
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
07/28/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Licensee, Jessica Sommerville TIME COMPLETED:
02:35 PM
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Licensing Program Analyst (LPA) Jennifer Lott conducted an unannounced case management visit to collect documents related to the 07/21/2022 visit. LPA was greeted at the front door by Licensee, Jessica Sommerville and granted entry after identifying herself and disclosing the purpose of her visit.

During LPA's visit, she collected the requested documents.

An exit interview was conducted with Licensee, Sommerville. A notice of site visit was given and must remain posted for 30 days.

Report was emailed to licensee due to printer issues. A read receipt confirms documents were received.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 07/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/28/2022
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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