<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628664
Report Date: 07/29/2021
Date Signed: 07/29/2021 11:54:02 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:SALCIDO, MIRNA FAMILY CHILD CAREFACILITY NUMBER:
376628664
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
07/29/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Mirna Salcido, ProviderTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) D. Sanchez made an unannounced Case Management inspection in response to the increase of capacity request. LPA was greeted and allowed entry into the facility by Mirna Salcido who was advised of the purpose of today’s inspection. LPA accompanied by Mirna conducted a general overall inspection of the facility. This facility is a two story, three bedroom, 2.5 bathrooms town house.

Daycare areas includes: living room, dining room, kitchen, hallway bathroom back porch and side yard. Off limits areas are : second floor and garage and are inaccessible through use of baby gate on stairs and lock on garage door.
LPA noticed that all required notices, License and forms were properly posted. The house smoke and carbon monoxide detectors are operable and fire extinguisher is fully charged. The day care bathroom was inspected; the toilet and faucets are operational. The kitchen drawers are secured and chemicals are not accessible to children.

The maximum number of children for whom care shall be provided when there is an assistant provider in the home, including children under age 10 who live in the licensee's home and the assistant provider's children under age 10, shall be either: Twelve (12) children with no more than four of whom may be infants or Fourteen (14) children, at least two of the children are at least six years of age and no more than three infants with landlord consent.
Facility is currently in substantial compliance; all requirements for a large license have been met. A large license for a maximum capacity of 14 children will be granted effective today 7/29/2021.

No deficiencies were cited during today's inspection. An exit interview was conducted with Mirna Salcido and a copy of this report left at the facility.

LPA provided notice of site visit and observed it being posted at the facility.
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1