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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100639
Report Date: 10/26/2021
Date Signed: 10/26/2021 04:23:11 PM

Document Has Been Signed on 10/26/2021 04:23 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:FARACO, PAULA FAMILY CHILD CAREFACILITY NUMBER:
376100639
ADMINISTRATOR:PAULA FARACOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 688-6818
CITY:ENCINITASSTATE: CAZIP CODE:
92024
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
10/26/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:08 PM
MET WITH:Paula FaracoTIME COMPLETED:
04:25 PM
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Licensing Program Analyst, Tyra Block, conducted a case management visit for the purpose of delivering the findings for a complaint received on licensee's previous facility. LPA also confirmed LIC 9224s were signed and on file for each of the children for Type A deficiency cited during most recent visit.

A Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE: DATE: 10/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/26/2021
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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