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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628215
Report Date: 06/30/2021
Date Signed: 06/30/2021 02:17:15 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:SARMIENTO, ANGELICA FAMILY CHILD CAREFACILITY NUMBER:
376628215
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
06/30/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Angelica Sarmiento, LicenseeTIME COMPLETED:
12:55 PM
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On 06/30/2021, at 12:15 p.m., Licensing Program Analyst (LPA), Michelle Hood conducted an unannounced Case Management Inspection and met with the Licensee, Angelica Sariento. LPA disclosed the purpose of the inspection was for a pending change of capacity and was granted entry into the facility by the Licensee. Six (6) children and two (2) staff were present in the facility during this inspection. This facility is a two story, 4 bedroom, 2.5 bathroom house. Licensee accompanied LPA inside and out of the facility during this inspection. The following areas used for child care are: play room 1 & 2, kitchen, living room, downstairs bathroom, and daycare children's area of the backyard. The off limits areas are garage, entire upstairs and area of the backyard outside of the daycare children's area. They are inaccessible through use of safety gates and latches.

On 06/03/2021, a pending request fire clearance was sent for 14 children. The following areas used for child care are: play room 1 & 2, kitchen, living room, downstairs bathroom, and daycare children's area of the backyard. The living room fire is properly barricaded. The off limits areas are garage, entire upstairs and area of the backyard outside of the daycare children's area. They are inaccessible through use of safety gates and latches. There are no bodies of water observed during time of inspection. There is a sufficient amount of age appropriate toys, games, and books available. The home was clean and orderly during inspection. The fire extinguisher is rated 2-A;10; BC, smoke alarm and carbon monoxide detector are operational. The is a working telephone in the home and all required forms are posted. Licensee stated that there are NO firearms or ammunition on the property. All adults living or working in the home have been fingerprint cleared and associated. LPA reviewed children's files. LPA obtained a copy of the facility roster. Pediatric CPR and First Aid certification expire 02/2023. LPA discussed with Licensee maintaining supervision of day children at all times. LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements, shaken baby syndrome and care and supervision. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care.

The maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there is no Qualified Assistant, 14 years of age or present, the capacity reverts back to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

A copy of the case management report, Notice of Site Visit – LIC 9213 and appeal rights (LIC 9058) will be e-mailed to the licensee and the licensee was advised that acknowledgement of receipt of the report and appeal rights are to be received within twenty-four hours. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

Upon the fire dept. corrections and an approved fire clearance, a Regular Large Family Child Care Home license may be issued for 14 children upon final file review.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Michelle HoodTELEPHONE: (691) 767-2241
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021
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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