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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628433
Report Date: 10/17/2019
Date Signed: 10/17/2019 03:08:47 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:RODRIGUEZ, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
376628433
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 0DATE:
10/17/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Sandra Rodriguez, Applicant TIME COMPLETED:
03:20 PM
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Licensing Program Analyst (LPA) Elizabeth Rivera conducted a pre-licensing inspection on 10/21/19 with applicant and her husband. This is a follow up pre-licensing inspection to inspect the home as applicant will not be able to use the basement area that was originally inspected by LPA for child care children. The two level story home was toured and inspected to ensure an environment safe for the care and supervision of children. 

The fire extinguisher 2A 10B:C is located in the kitchen. The carbon monoxide detector, and smoke detector meet requirements and are operational.  All hazardous items were latched/locked and secured out of reach of children.  There are no bodies of water on the property.  Licensee states that there are no weapons in the home. 

Applicant will use the following areas for child care: living room, dining room, bathroom 1 located in the first floor, bathroom 2 located in the lower level, room in the lower level, and fenced back patio. Applicant removed tall play structure from the patio. Off limits areas include: front yard, bedroom 1, bedroom 2, garage, and basement. They are made inaccessible to day care children through the use of door locks, and door knob covers. Stairs are barricaded using safety gates and per applicant wall heater is not used but will be barricaded.

The maximum capacity for a small family child care home: 4 infants only (infants mean any children under 24 months); or 6 children with no more than 3 infants; or 8 children with no more than 2 infants, 1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.
SUPERVISOR'S NAME: Monica CuddyTELEPHONE: (619) 767-2249
LICENSING EVALUATOR NAME: Elizabeth RiveraTELEPHONE: (619) 767-2200
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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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