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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376701226
Report Date: 10/04/2022
Date Signed: 10/04/2022 10:33:02 AM

Document Has Been Signed on 10/04/2022 10:33 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:CHILDREN'S CHOICE ACADEMYFACILITY NUMBER:
376701226
ADMINISTRATOR:SHANNON SPENCERFACILITY TYPE:
830
ADDRESS:12464 WOODSIDE AVENUETELEPHONE:
(619) 561-8880
CITY:LAKESIDESTATE: CAZIP CODE:
92040
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
10/04/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:TIME COMPLETED:
10:35 AM
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On 10/4/2022 at 10AM, Licensing Program Manager (LPM), Monica Cuddy, and Licensing Program Analysts (LPA) Nancy Diaz and Annette Sutherland conducted an office meeting with Licensee, Jennifer House and Site Director, Shannon Spencer. Licensee requested the office meeting.

The following were discussed:

- The Department's role
- Licensee's responsibilities
- Recent Type A violation cited during a complaint investigation
- Recent citation on Driver endorsement in the school-age program. Licensee stated that they will get rid of their vans and transport children using another type of vehicle (SUV's)

Facility representatives were provided information on TSP - Technical Support Program through the Department's Advocate Program.

LPA also provided Licensee an amended report from an original complaint report dated, 09/08/2022. Licensee was advised that they post and provide copies of the licensing report to parents/guardian of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

Access our updated Regulation & Forms by using our WEBSITE: http://ccld.ca.gov
Duty Line: (619) 767-2248, Monday thru Friday 8am-5pm.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/04/2022
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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