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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 306006097
Report Date: 08/22/2024
Date Signed: 08/22/2024 02:57:20 PM

Document Has Been Signed on 08/22/2024 02:57 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME:TESSA'S PLACE 4FACILITY NUMBER:
306006097
ADMINISTRATOR/
DIRECTOR:		AVENDANO, ELEONORFACILITY TYPE:
740
ADDRESS:2825 CALLE GUADALAJARATELEPHONE:
(949) 331-3822
CITY:SAN CLEMENTESTATE: CAZIP CODE:
92673
CAPACITY: 6CENSUS: 3DATE:
08/22/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Rowena Manalili and Mark Ryan CruzTIME VISIT/
INSPECTION COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced Plan of Correction (POC) visit to follow up on deficiencies cited on 07/18/2024. LPA was greeted and granted entry into the facility and explained the reason for the visit. Administrator Mark Ryan Cruz and Office Manager Justin Cruz arrived during the visit.

Deficiency cited under Title 22 Regulation 87303(e)(2) pertaining to Water Temperature has been cleared. During today's visit, water temperature is within regulation parameters. Licensee has complied with the POC.
Deficiency cited under Title 22 Regulation 87608(a)(1) pertaining to Maintenance and Operation has been cleared. During today's visit, Kitchen has been cleaned. Licensee has complied with the POC.


Licensee has been advised to maintain compliance in all items cited.




Exit interview conducted and a copy of this report was left at the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Kimberly Lyman
LICENSING EVALUATOR SIGNATURE: DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/22/2024
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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