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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610641
Report Date: 10/10/2023
Date Signed: 10/10/2023 03:50:25 PM

Document Has Been Signed on 10/10/2023 03:50 PM - It Cannot Be Edited

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:VILLARREAL, JUDITH FAMILY CHILD CAREFACILITY NUMBER:
136610641
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Judith Villarreal, applicantTIME COMPLETED:
03:55 PM
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Licensing Program Analyst (LPA) Edgar Campana conducted an announced prelicensing inspection with applicant, Judith Villarreal. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This one story story, 4 bedroom, 2 bathroom home was toured and inspected. 

Applicant will use the following areas for child care: living room, hallway bathroom, dining room, and back yard. Off limits areas include: garage, kitchen, all bedrooms, master bedroom bathroom, and laundry room. Off limits areas are made inaccessible to day care children through the use of door locks and fences. There are no bodies of water observed during time of visit. Fire extinguisher, smoke and carbon monoxide detectors meet requirements and are operational. Detergents, cleaning compounds, and medicines are inaccessible to children in care. Children’s toys and play equipment are available. The applicant has a working cell phone.  Applicant indicated there are no firearms in the home. During inspection, no poisons were observed present in the home.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE: DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/10/2023
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: VILLARREAL, JUDITH FAMILY CHILD CARE
FACILITY NUMBER: 136610641
VISIT DATE: 10/10/2023
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The applicant provided proof of control of property by means of grant deed. Applicant can provide care to a maximum of eight (8) children only if Parent Notification, Additional Children in Care form (LIC 9150) is on file.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Home, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (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.

On this date, 10/10/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: VILLARREAL, JUDITH FAMILY CHILD CARE
FACILITY NUMBER: 136610641
VISIT DATE: 10/10/2023
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A license for a small family child care license may be issued after final file review.

Exit interview conducted and report was reviewed with the applicant, Judith Villarreal in Spanish.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023
LIC809 (FAS) - (06/04)
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