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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625232
Report Date: 10/11/2022
Date Signed: 10/11/2022 02:38:11 PM

Document Has Been Signed on 10/11/2022 02:38 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:ROMERO, AMBRIA FAMILY CHILD CAREFACILITY NUMBER:
376625232
ADMINISTRATOR:AMBRIA ROMEROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 450-4580
CITY:SAN DIEGOSTATE: CAZIP CODE:
92120
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/11/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
02:06 PM
MET WITH:Ambria RomeroTIME COMPLETED:
02:40 PM
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On 10/11/22, Licensing Program Analyst (LPA), Tyra Block, conducted an inspection for the purpose of confirming licensee is adhering to plan of correction established during visit on 9/20/22. Present at the home were 10 children, including 3 infants and helper, Ms. Jackie. Facility was within ratio and capacity during the visit and licensee is in compliance with plan of correction in regards to ratio and plan for pick up from school (neighbor/ friend picks up and drops off children from school). Licensee stated no new children have enrolled since last visit.

LPA conducted exit interview with licensee, Ambria Romero, and provided this licensing report and Notice of Site Visit electronically due to technical difficulties. Notice of Site Visit must remain posted for 30 days.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
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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