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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376617485
Report Date: 07/05/2019
Date Signed: 07/05/2019 12:44:20 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:ACOSTA, ALMA FAMILY CHILD CAREFACILITY NUMBER:
376617485
ADMINISTRATOR:ALMA ACOSTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 280-1515
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY:14CENSUS: 3DATE:
07/05/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Alma AcostaTIME COMPLETED:
10:15 AM
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THIS IS A DATA ENTRY OF A MANUALLY-WRITTEN REPORT. PLEASE SEE ORIGINAL LIC 809 FOR SIGNATURES.

An unannounced random inspection was conducted today by LPA, Nancy Diaz. There were 3 children observed present with licensee, Alma Acosta and her helper, Claudia Reynoso. LPA conducted a tour of the home to ensure the health and safety of children in care. Licensee is using the following areas for day care: living room, dining, kitchen, hallway bathroom, bedroom (to the right of the bathroom) and back fenced yard. Off-limit area is the licensee's bedroom. Mrs. Acosta stated that she does not have any weapons. There were no bodies of water observed within the premises. There is a fire extinguisher, smoke detector and carbon monoxide present in the home that are operable. The home has sufficient ventilation for safety and comfort. The home provides sufficient toys, play equipment and materials available for children's use. The home maintains a working telephone service. Outdoor play area is fenced. The licensee maintains current emergency information on all the children. Licensee's Pediatric CPR/First Aide certificate is valid thru 12/2020. A handout was provided to Mrs. Acosta today on "Effects of Lead Exposure". Mrs. Acosta shall provide a copy of this handout to all the daycare parents.
Facility has not exceeded the capacity specified on the licensee. Licensee resides in the home with her husband, Jesus Hernandez. An updated LIC 279 to reflect that Mr. Hernandez is now a resident of the home. There are no new adults living or working in the home over the age of 18 years. All individuals subject to criminal record review have obtained criminal record clearance prior to working, residing or volunteering.
NO DEFICIENCY CITED TODAY.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Nancy DiazTELEPHONE: (619) 767-2207
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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