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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 493009021
Report Date: 12/03/2019
Date Signed: 12/03/2019 11:33:19 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME:ESPINAL, LOURDES FCCHFACILITY NUMBER:
493009021
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 6DATE:
12/03/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:10 PM
MET WITH:Lourdes EspinalTIME COMPLETED:
05:00 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
A case management inspection was conducted to the facility by Licensing Program (LPA) Leticia Rosales-Meza in response to an increase capacity application received by the Department on 11/12/19. The licensee is requesting a capacity of 14. A review of staff records indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions

The facility is toured inside and outside. The facility’s operating hours are 7:00 AM to 6:00 PM, Monday-Saturday. The floor plan submitted by the licensee was reviewed and verified. The off-limits areas of the home are two bedrooms, and were made inaccessible by door knob covers. The home was observed to be clean and orderly, and was at a comfortable indoor temperature. Electrical outlets are covered and drapery cords are not accessible. The children's bathroom is free of toxins. There is a working telephone in the home. Items which could pose a danger to children (detergents, cleaning compounds, and medications) were stored out of the reach of children. There is a working smoke detector, carbon monoxide detector and fire extinguisher in the home. The licensee has a current roster of children in care and has conducted an emergency drill within the past six months. There are no firearms in the home, and none were observed during the visit. The children use the backyard as the outdoor play area and it is completely fenced. There are no bodies of water on the property. All licensing reports are public information and must be made available upon request for at least three years.

Pediatric CPR and Pediatric First Aid cards expire 12/2020 for Lourdes Espinal, Licensee and Jazmin Beltran, assistant.

The Fire Marshall inspected and granted the fire clearance on 11/19/19.

The increase capacity to 14, as a Large Family Child Care Home is granted as of today, 12/03/19.

There were no violations of Title 22 Regulations cited during today's visit..

NOTICE OF SITE VISIT SHALL BE POSTED FOR 30 DAYS FROM TODAY'S VISIT
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Leticia RosalesTELEPHONE: (707) 588-5061
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019
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