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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629184
Report Date: 05/06/2022
Date Signed: 12/21/2023 03:21:07 PM

Document Has Been Signed on 12/21/2023 03:21 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:BORDWELL, SHADY FAMILY CHILD CAREFACILITY NUMBER:
376629184
ADMINISTRATOR:SHADY BORDWELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 519-2549
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
05/06/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Shady BordwellTIME COMPLETED:
01:45 PM
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On 05/06/22 at 1:15pm, LPA Adrian Castellon conducted a case management inspection at the request of licensee Shady Bordwell. Licensee wishes to use her front yard for childcare purposes.

The front yard is fully fenced and is free of hazards or debris. Licensee Bordwell recently placed a new fence along the front yard. Licensee also installed artificial turf in the front yard.

The front yard may be used for daycare purposes.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 05/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/06/2022
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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