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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364819289
Report Date: 09/17/2021
Date Signed: 09/17/2021 01:38:35 PM

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GRANADOS FAMILY CHILD CAREFACILITY NUMBER:
364819289
ADMINISTRATOR:GRANADOS, LIDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 562-4238
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY:14CENSUS: 1DATE:
09/17/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:18 PM
MET WITH:Lidia Granados, Licensee
Astrid Granados, Assistant		TIME COMPLETED:
01:37 PM
NARRATIVE
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Translated in Spanish to the Licensee by Astrid (Assistant)

Licensing Program Analysts(LPA) Elyse Jones arrived at the facility to conduct a Case Management inspection for the purpose of addressing separate matters that were discovered during an inspection at the facility. During the inspection LPA conducted a tour of the facility and census were taken. During record review it was discovered the facility did not have a completed roster and files were missing for C1 and C2.

See LIC 809-D for deficiency cited

An exit interview was conducted with the facility Licensee. Notice of Site Visit was left with the Licensee and must be posted for 30 days.

A copy of the report was left at the facility and must be made available to the public for three years upon request.

SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse JonesTELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2021
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GRANADOS FAMILY CHILD CARE
FACILITY NUMBER: 364819289
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2021
Section Cited

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Child's Records 102421(a)
The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). The requirement was not met as evidenced by:
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Based on the interview and record review the Licensee did not meet Childs Records which poses an potential Health, Safety & Personal Rights risk to the children in care. Assistant stated there are no records available for review for C1 and C2.
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Type B
09/17/2021
Section Cited

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Operation of a Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not as evidenced by:
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Based on the interview and record review the Licensee did not meet Childs Records which poses an potential Health, Safety & Personal Rights risk to the children in care. Assistant stated there is not a completed roster available for review.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Aaron RossTELEPHONE: (951) 320-2023
LICENSING EVALUATOR NAME: Elyse JonesTELEPHONE: (951) 897-2468
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021
LIC809 (FAS) - (06/04)
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