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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376615406
Report Date: 07/05/2019
Date Signed: 07/05/2019 02:48:47 PM

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:TISCARENO, MARIA FAMILY CHILD CAREFACILITY NUMBER:
376615406
ADMINISTRATOR:TISCARENO, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 461-4756
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91977
CAPACITY:14CENSUS: 2DATE:
07/05/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Maria TiscarenoTIME COMPLETED:
03:00 PM
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An unannounced plan of correction inspection was conducted by Licensing Program Analysts (LPA) Samantha Salunga and Michael Morales-DeSilvestore regarding deficiencies that were cited on 07/01/2019. There were 2 children in care during time of visit. Upon arrival LPA's met with Licensee, Maria Tiscareno and toured the facility to ensure plan of corrections for the below deficiencies were met.

On 07/01/2019, Licensee was issued a Type A violation under section 102417(g)(5) where LPA Salunga observed the mesh material that was surrounding Licensee's pool fence to be in bad condition. Mesh fencing was observed ripped apart, making the chain link fencing climbable. Self-latching gate was also not able to self-latch at all distances. LPA's tested and observed self-latching gate to self-latch at all distances today, 07/05/2019. Mesh material around the pool fence was also observed to be in good repair. Type A deficiency is cleared today and Licensee was given a copy of the Plan of Correction letter.

LPA Salunga also cleared Licensee's two Type B violations that were issued on 07/01/2019 under section 102417(g)(8) and 102417(g)(9)(A)(1). LPA Salunga obtained updated children's roster and a copy of Licensee's fire drill log. Deficiencies are cleared and Licensee was given a copy of the Plan of Correction letter.

No deficiencies observed in the areas inspected during today's inspection. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. LPA's observed Licensee post notice of site visit. LPA's reviewed this report with Licensee prior to obtaining her signature.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Samantha SalungaTELEPHONE: (619) 767-2209
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2019
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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