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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628175
Report Date: 10/27/2022
Date Signed: 10/27/2022 12:34:04 PM

Document Has Been Signed on 10/27/2022 12:34 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:LARRAGA, JANELLE FAMILY CHILD CAREFACILITY NUMBER:
376628175
ADMINISTRATOR:JANELLE LARRAGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 888-2034
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
10/27/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Janelle LarragaTIME COMPLETED:
12:30 PM
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On 10/27/2022 at 11:40am, Licensing Program Analyst (LPA), David Miller conducted an unannounced case management inspection in order to deliver an amended report originally created on 10/18/2022. Upon arrival LPA met with the licensee, Janelle Larraga and explained the purpose of the visit. There were five children present during the visit.

LPA discussed and provided the Technical Support Program (TSP) to the licensee.

No deficiencies cited.

Exit interview was conducted with the licensee Janelle Larraga. Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 10/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/27/2022
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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