<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376619537
Report Date: 11/13/2019
Date Signed: 11/13/2019 03:07:49 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:MUJICA, DIANA FAMILY CHILD CAREFACILITY NUMBER:
376619537
ADMINISTRATOR:DIANA MUJICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 934-6643
CITY:CHULA VISTASTATE: CAZIP CODE:
91913
CAPACITY:14CENSUS: DATE:
11/13/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Diana MujicaTIME COMPLETED:
03:10 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
An unannounced random inspection was conducted today. Upon arrival LPA observed 12 children in care with the licensee. Licenee Diana Mujica was present along with two cleared assistants. Children were participating in various indoor activities. LPA conducted a tour of the home to ensure the health and safety of children. Licensee is using the following areas for daycare: living room, dining, kitchen, daycare room and the covered driveway. The following areas are off-limits to children: second floor which os properly barricaded.
Mrs. Mujica stated that she does not maintain weapons in the home. There were no bodies of water observed within the premises. All cleaners, toxics, medications and other hazardous substances are inaccessible to children in care via latched cabinets in the kitchen and hallway bathroom. Fire extinguisher, carbon monoxide detector and smoke detectors present in the home meet State Fire Marshall standards. The home is kept clean and orderly with sufficient ventilation for safety and comfort. The home provides safe toys, play equipment and materials. The home maintains a working telephone service.
Outdoor play area is fully fenced backyard. The licensee maintains a current children’s roster. Facility conducts a fire/emergency disaster drills and documentation of the date and time of drill was observed. The licensee and helpers have completed CPR/First Aid training, certificates are valid thru Jun 2021.
Facility has not exceeded the capacity specified on the license. 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 or exemption prior to working, residing or volunteering.

CONTINUED ON PAGE 2
SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MUJICA, DIANA FAMILY CHILD CARE
FACILITY NUMBER: 376619537
VISIT DATE: 11/13/2019
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Licensees can request to be on a distribution list for the Quarterly Updates by emailing: Childcare advocatesprogram@dss.ca.gov.

"Mandated Reporter Training" has been completed. Adult immunization requirement has been met.

No citations issued.

Community Care Licensing WEBSITE: http://www.ccld.ca.gov


SUPERVISOR'S NAME: Joe CarrascoTELEPHONE: (619) 767-2243
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2