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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627748
Report Date: 07/08/2021
Date Signed: 07/08/2021 01:04:44 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:TAPIA HERNANDEZ, ARIANA FAMILY CHILD CAREFACILITY NUMBER:
376627748
ADMINISTRATOR:ARIANA TAPIA HERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 341-9739
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY:14CENSUS: 6DATE:
07/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Licensee, Ariana Tapia Hernandez TIME COMPLETED:
08:55 AM
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Licensing Program Analyst (LPA), Jennifer Lott conducted an announced Case Management visit at the licensee's request to inspect an above ground pool and fencing for compliance. LPA was greeted at the front door by Licensee, Ariana Tapia Hernandez and granted entry after identifying herself and disclosing the purpose of her visit.

The licensee has placed an above ground pool in the backyard with access through a locked gate on the side of the home. Fencing measures 5 feet in height and is constructed so that the fence does not obscure the pool from view. The side gate swings away from the pool, self closes with a self latching device that is no more than 6 inches from the top of the gate. Although this is an above ground pool, ladders have been removed making the pool inaccessible when not in use. Licensee submitted a new facility sketch to include the pool.

At this time, further review and discussion with management is needed before the pool use is approved.

Based on today’s visit, no deficiencies were observed at this time. An exit interview was conducted with Licensee, Tapia Hernandez. A copy of this report, Appeal and Licensee Rights (LIC 9058) as well as Notice of Site Visit Form (LIC 9213) have been provided. Signature below confirms receipt of these documents. Licensee acknowledges that the LIC 9213 is required to be posted for 30 days.
SUPERVISOR'S NAME: Tashima DanielTELEPHONE: (619) 629-8413
LICENSING EVALUATOR NAME: Jennifer LottTELEPHONE: 619-782-8300
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021
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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