Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624202
Report Date: 04/13/2016
Date Signed 04/13/2016 10:42:50 AM

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:HIBBERT, BARBARA FAMILY CHILD CAREFACILITY NUMBER:
376624202
ADMINISTRATOR:BARBARA HIBBERTFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 761-9982
CITY:SAN DIEGOSTATE: CAZIP CODE:
92114
CAPACITY:14CENSUS: 1DATE:
04/13/2016
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Barbara HibbertTIME COMPLETED:
10:50 AM
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LPA Angel Richards arrived at the facility for the purpose of conducting a Plan of Correction visit in regards to citations issued on 3/18/16. LPA met with the licensee. Also present was the licensee's child and 1 daycare child. LPA toured the home. The items in the home belonging to Christian Davis (uncleared adult) have been removed. All citations issued on 3/18/16 have been cleared.

No deficiencies cited. A Notice of Site Visit must be posted for 30 days.
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Mary A RichardsTELEPHONE: 619-767-2208
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2016
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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