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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628221
Report Date: 02/23/2022
Date Signed: 02/25/2022 10:00:38 AM


Document Has Been Signed on 02/25/2022 10:00 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:ALVAREZ, ALEXIZ FAMILY CHILD CAREFACILITY NUMBER:
376628221
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
02/23/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Alexis AlvarezTIME COMPLETED:
12:30 PM
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On 02/23/22 at 11:45 am, Licensing Program Analyst (LPA) Adrian Castellon conducted an announced capacity increase inspection with licensee Alexis Alvarez. Purpose of the inspection is to ensure that all requirements are met so that a large license capacity 14 may be issued A fire clearance report dated 02/16/22 was received by the SDRO. Licensee Alvarez will use the following areas for child care: family room, kitchen and hallway bathroom. Off limits areas include: bedrooms which are properly secured. Licensee will utilize a fully fenced backyard for outdoor activities. There are no bodies of water observed during time of visit. Licensee states that there are no firearms in the home. The fire extinguisher, carbon monoxide detector and smoke detector meet requirements and are operational. There are 4 children present along with a cleared assistant.

A large license may be issued after a final file review. No citations issued on this date.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2022
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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