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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628231
Report Date: 05/02/2019
Date Signed: 05/02/2019 11:35:49 AM

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:CARROLL, EURANIKA FAMILY CHILD CAREFACILITY NUMBER:
376628231
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
05/02/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Euranika CarrollTIME COMPLETED:
11:00 AM
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Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an unannounced inspection at the facility. LPA advised the Licensee of the visit’s purpose and was granted facility entry.

The Licensee provides an art based educational approach towards care. The attached garage space was arranged to be the children’s art studio. Only art related materials are located inside this space. The provider purchased the home with the garage intended to only be used for children's art activities. The provider previously agreed not to use this area until approved by Community Care Licensing (CCL).

The art studio/garage was observed to be specific to the artistic needs of children. No health or safety hazards were observed in the art studio/garage. The Licensee states the children will be in the art studio/garage daily at most 1.5 hours. Child drop and pick ups are not conducted in the art studio/garage.

Children will only be in the art studio/garage daily beyond 1.5 hours. The provider acknowledged that children will not be left alone in the art studio/garage area without staff supervision. Child pick up and drop offs will not be conducted in the art studio/garage area. Based on today's visit, use of the art studio/garage for the care and supervision of children is approved.

LPA provided the Licensee with the Notice of Site Visit – LIC 9213, which is to be posted for thirty (30) days. An exit interview was conducted with the Licensee, who was provided a copy of their Appeal/Licensee Rights (LIC 9058 1/16). Their signature on this form acknowledges receipt of these rights.
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: JoAnn R LegaspiTELEPHONE: (619) 767-2239
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2019
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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