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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628323
Report Date: 08/06/2019
Date Signed: 08/06/2019 01:22:30 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:GONZALEZ, ALMA FAMILY CHILD CAREFACILITY NUMBER:
376628323
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
08/06/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Alma GonzalezTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) Yolanda Baez arrived at the facility for an unannounced case-management inspection for an increase of capacity. LPA Baez met with Licensee, Alma Gonzalez. There was one day care child present at the time of the inspection. This 3 bedroom and 2 bathroom home was toured and inspected to ensure environment is safe for the care and supervision of children.

Licensee will use the following areas for child care: living room, hallway bathroom, bedroom #1, and fenced patio. The following areas are made inaccessible by the use of door knobs and safety gates: kitchen, dining room, second living room, master bedroom and bathroom, bedroom #2, and attached garage. There are no bodies of water observed during time of visit. The fire extinguisher is rated 2A 10B:C and is located in the kitchen area. There is an operational smoke alarm and carbon monoxide monitor in the home. No physical plant changes have been added since the pre-licensing inspection dated 05/30/19.

LPA printed out the capacity for a large license and reviewed the new capacity information with Licensee. There were not any deficiencies issued throughout today's inspection. Notice of Site Visit is to be posted for 30 days. A fire clearance was granted for 14 children on 07/26/19. A large license, capacity of 14 children, will be issued effective today.

SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Yolanda BaezTELEPHONE: (619) 767-2201
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2019
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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