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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625439
Report Date: 12/10/2020
Date Signed: 12/10/2020 11:33:54 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:DELGADO, ALICIA & JOSE FAMILY CHILD CAREFACILITY NUMBER:
376625439
ADMINISTRATOR:ALICIA & JOSE DELGADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 741-4788
CITY:LEMON GROVESTATE: CAZIP CODE:
91945
CAPACITY:14CENSUS: 6DATE:
12/10/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:51 AM
MET WITH:Jose DelgadoTIME COMPLETED:
11:00 AM
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On December 10, 2020 at 10:51 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an inspection to correct the 11/25/2020 Licensing report. Due to the COVID 19 outbreak, this inspection was done as a tele visit via the FaceTime platform. Present in the daycare were (2) infants, three (3) toddlers, one (1) daycare school aged child, and both Licensees.

A copy of the original 11/25/2020 report and a copy of the corrected 11/25/2020 report was emailed to the Licensees. The prior report, dated 11/25/2020, contained the word "NAME" on the second line. The corrected report reflects the word "NAME" deleted from the second line of the original 11/25/2020 report.

A Notice of Site Visit (LIC 9213) is to be posted for thirty (30) days. LPA electronically provided this document to Licensee Jose Delgado. An exit interview was conducted. A copy of this report and Licensee/Appeal Rights (LIC 9058) will be e-mailed to the Licensee. The Licensee was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2020
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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