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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376615823
Report Date: 03/24/2021
Date Signed: 03/24/2021 01:07:40 PM

Document Has Been Signed on 03/24/2021 01:07 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:GRUBBS, ELIZABETH FAMILY CHILD CAREFACILITY NUMBER:
376615823
ADMINISTRATOR:ELIZABETH GRUBBSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 884-7235
CITY:SANTEESTATE: CAZIP CODE:
92071
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 9DATE:
03/24/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:47 PM
MET WITH:Elizabeth GrubbsTIME COMPLETED:
01:10 PM
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On 3/24/2021 at 12:47 PM, LPA Nancy Diaz conducted an unannounced case management inspection in reference to licensee's request to remove Bedroom #2 and add Bedroom #1 to space accessible to children. This inspection was conducted via Facetime due to COVID-19 pandemic restriction.

Observed present today were 9 children (2 children are under age two). Children were observed napping. Helper Katie O'Connor was also present. A tour of the home was conducted. The following areas are accessible to children: living room, family room, bedroom #1, master bedroom, play room and playroom bathroom. Off limit areas are: Bedroom #2, kitchen, dining room, master bathroom, hallway bathroom and garage.

No deficiency cited today.

An exit interview was conducted with Mrs.Grubbs. A copy of this report along with Appeal Rights (LIC9058) will be sent via e-mail to Mrs. Grubbs. She will will confirm receipt of these report via e-mail and the reply of confirmation will serve as the signature acknowledging these rights. Email address is: Elizabethgrubbs@yahoo.com.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2021
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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