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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627446
Report Date: 08/21/2024
Date Signed: 08/22/2024 01:13:31 PM


Document Has Been Signed on 08/22/2024 01:13 PM - It Cannot Be Edited

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:SALAZAR, NAIROBY FAMILY CHILD CAREFACILITY NUMBER:
376627446
ADMINISTRATOR:NAIROBY SALAZARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 708-8728
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY:14CENSUS: 4DATE:
08/21/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Nairoby SalazarTIME COMPLETED:
03:10 PM
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On 8/21/24 at 2:10 p.m., Licensing Program Analyst (LPA), Adrian Castellon arrived at the facility to conduct a case management - License initiated inspection. Upon arrival LPA, met with licensee Nairoby Salazar and proceeded to inspect newly constructed room (daycare), bathroom #2, and fully fenced backyard.

A City of Chula Vista Inspection Record report with final inspection date of 7/26/24 was reviewed by LPA Castellon on this date.

The daycare room was observed to be orderly, free of hazards and has adequate heating, lighting and ventilation. The restrooms and hand washing areas were observed to be in safe, sanitary and operating condition.  The fully fenced backyard is free of any debris or harmful objects.

During the insepction, LPA Castellon discussed the following: Infant Safe Sleep requirements (including 15 minute check) and unusual incident/injury reporting requirements. LPA Castellon reviewed a child's folder and licensee and assistant folder.

LPA Castellon reminded licensee Salazar to submit updated facility sketch (indoor and outdoor). Daycare room and bathroom #2 may be used for daycare purposes.

Exit interview was conducted, report reviewed, and Appeal Rights discussed with licensee. A Notice of Site Visit was given and must remain posted on, or immediately next to, interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:
DATE: 08/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/21/2024
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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