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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629128
Report Date: 03/06/2024
Date Signed: 03/06/2024 12:58:16 PM

Document Has Been Signed on 03/06/2024 12:58 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:MOORE, CHERYL FAMILY CHILD CAREFACILITY NUMBER:
376629128
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 1DATE:
03/06/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Cheryl MooreTIME COMPLETED:
01:15 PM
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On March 6, 2024, Licensing Program Analysts (LPAs), Gloria Gonzalez conducted an unannounced Plan of Correction (POC) inspection at the facility. Purpose of this inspection is to ensure citations issued during an annual inspection dated 9/1/23 were corrected. Upon arrival, LPA met with Licensee, Cheryl Moore and proceeded to tour the facility. 

There was one (1) child and Licensee, and Licensee's husband during today’s inspection.

The following citations issued on 9/1/23 were corrected as follows:

Licensee provided a copy of the Mandated Reporter Training Certificate dated 2/28/24.
The Disaster drill log was documented on 12/8/23.
LPA reviewed children's files and all have required documents including Immunization's and LIC700 Emergency forms.

LPA provided Licensee, Cheryl Moore with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days.  LPA observed form LIC 9213 posted on the bulletin board at the entrance. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. An exit interview was conducted with the licensee, who was provided a copy of their Licensee Appeal Rights (LIC 9058 1/16).

No deficiencies cited.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 03/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2024
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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