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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628150
Report Date: 05/19/2022
Date Signed: 05/19/2022 11:49:07 AM


Document Has Been Signed on 05/19/2022 11:49 AM - 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:CONTRERAS HERNANDEZ, LILIA FAMILY CHILD CAREFACILITY NUMBER:
376628150
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
05/19/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Licensee Lilia Contreras Hernandez and spouse Francisco DuranTIME COMPLETED:
11:55 AM
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On 5/16/22 @ 11:15 a.m., Licensing Program Analyst, Joelle Redding, made an unannounced visit to evaluate the facility for a requested increase in capacity from a small family home to a large family home. The request was received on 4/8/22 and the fire clearance was approved on 4/26/22. Today there were no children present as Licensee is expecting within the next couple of weeks. She will resume care in the summertime.

During this visit, LPA inspected the facility and outdoor space for safety and compliance with Title 22 regulation, reviewed children and staff records (spouse), and ensured the child care roster was current and complete. Capacity limitations were reviewed and a capacity limitation handout was provided. Licensee understands that if she does not have an assistant present, she may not operate at a large family capacity of 12, up to 14 children, and must remain at a small with no more than 6 up to 8 children. Licensee is reminded that form LIC 9150, Notice of Additional Children in Care, is to be provided should she exceed 6 at the small family capacity or 12 at the large family capacity. The additional two children must be school age with one child in kindergarten/elementary school and one child at least age six.

Upon final file review, Licensee's increase in capacity is granted and an updated License will be sent for posting.
SUPERVISOR'S NAME: Renesha PackTELEPHONE: (619) 767-2155
LICENSING EVALUATOR NAME: Joelle ReddingTELEPHONE: (619) 767-2222
LICENSING EVALUATOR SIGNATURE:
DATE: 05/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/19/2022
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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