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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629116
Report Date: 09/09/2021
Date Signed: 09/15/2021 07:02:34 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 CAREFACILITY NUMBER:
376629116
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
09/09/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Melissa PuentesTIME COMPLETED:
09:25 AM
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On 09/09/21 at 8:45am, Licensing Program Analyst (LPA) Adrian Castellon conducted an announced capacity increase inspection with licensee Melissa Puentes. Purpose of the visit is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3 and so that a large license capacity 14 may be issued A fire clearance report dated 08/18/21 was received by the SDRO. This 6 bedroom, 3 bath home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant is purchasing the home and has provided proof. Licensee Puentes 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. Licensee will utilize the front yard for outdoor activities. There are no bodies of water observed during time of visit. Licensee states that there are no firearms in the home. The fire extinguisher, carbon monoxide detector and smoke detector meet requirements and are operational.

After a final file review, a large license capacity 14 may be issued.

SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021
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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