376629116-6-17-2021-20-CC-ACAN-C43JER-20210617065933

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376629116
Report Date: 06/16/2021
Date Signed: 06/17/2021 07:00:27 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:	PUENTES MONTANE, MELISSA FAMILY CHILD CARE		FACILITY NUMBER:	376629116
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	06/16/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Melissa Puentes		TIME COMPLETED:	10:00 AM

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) Adrian Castellon conducted an announced Pre-Licensing inspection with applicant, Adham Naseeb. Purpose of the visit is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3. Applicant Puentes recently submitted a change of location application. This 6 bedroom, 3 bath home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant rents the facility and has provided proof by rental agreement. Applicant has provided LPA with a completed copy of the LIC9149, Landlord Consent allowing Applicant to operate at the full capacity of 8 children. Applicant will use the following areas for child care: daycare room, kitchen, dining area, hallway bathroom, and living room. Off limits areas include: garage, back patio and all bedrooms. There are no stairs in the home. Applicant will utilize fenced front yard for outdoor activities. There are no bodies of water observed during time of visit. The fire extinguisher, carbon monoxide dectecor and smoke detector meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces. Children’s toys and play equipment are available. Applicant states there are no firearms or other weapons in the home. Applicant has completed the 8 hours of preventative health with the lead poison prevention. Pediatric CPR and First Aid certifications expire on 04/23. Required documents are posted. Applicant and her boyfriend are the only adults residing in the home and have been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18^th birthday must be fingerprinted within 30 days. Applicant is exempt from Mandated Reporter AB1207 training has been completed. LPA Castellon reviewed an child's folder during the inspection.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: PUENTES MONTANE, MELISSA FAMILY CHILD CARE	FACILITY NUMBER: 376629116
	VISIT DATE: 06/16/2021

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Applicant was advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248. LPA's discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov

Applicant states that he will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children. LPA reviewed this report with Applicant prior to obtaining his signature.

Prior to licensure, the following will be corrected:

ensure that the fireplace edges are secured

Applicant states that she will submit photo of correction to LPA by 06/16/2021. Once correction has been completed, a small license of a capacity of 8 children maybe issued upon final file review.

SUPERVISOR'S NAME: Cynthia Gray	TELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian Castellon	TELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021

LIC809 (FAS) - (06/04)

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