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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376105023
Report Date: 02/17/2023
Date Signed: 02/17/2023 03:32:19 PM

Document Has Been Signed on 02/17/2023 03:32 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:CHILDREN'S CHOICE ACADEMYFACILITY NUMBER:
376105023
ADMINISTRATOR:KRISTEN GEORGEFACILITY TYPE:
850
ADDRESS:9748 LOS COCHES ROAD, SUITE 12TELEPHONE:
(619) 561-1178
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 74TOTAL ENROLLED CHILDREN: 74CENSUS: 49DATE:
02/17/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:VP Operations, Jenni Grawvunder TIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Jennifer Lott conducted an unannounced Case Management visit. LPA was greeted at the front door by Jenni Grawvunder and was granted entry after identifying herself and disclosing the purpose of her visit.

The visit was initiated due to director providing the new director packet for licensing.
During today’s visit, LPA collected the new director packet for processing.

Based on today’s visit, no deficiencies were observed at this time. Exit interview conducted and report was reviewed with Jenni Grawvunder. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Jennifer Lott
LICENSING EVALUATOR SIGNATURE: DATE: 02/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/17/2023
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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