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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701204
Report Date: 03/30/2022
Date Signed: 03/30/2022 09:38:07 AM

Document Has Been Signed on 03/30/2022 09:38 AM - 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CHILDREN'S PARADISE INC-MELROSEFACILITY NUMBER:
376701204
ADMINISTRATOR:CHRISTINA JENKINSFACILITY TYPE:
840
ADDRESS:145 N MELROSE DR STE 100TELEPHONE:
(760) 724-5600
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY: 26TOTAL ENROLLED CHILDREN: 26CENSUS: 19DATE:
03/30/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Shaina CormierTIME COMPLETED:
09:45 AM
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On this date, Licensing Program Analyst (LPA) Alaina Wilburn conducted a case management inspection and delivered amended reports that were initially provided to the facility on September 1, 2021. LPA met with Director Shaina Cormier, to deliver an amended complaint investigation report #10-CC-20210824160248

No deficiencies were cited on this date. An exit interview was conducted, a Notice of Site Visit (LIC 9213) was posted, appeal rights were discussed and provided, and a copy of this report was given to the facility representative below.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Alaina Wilburn
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2022
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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