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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314099
Report Date: 11/15/2022
Date Signed: 11/15/2022 01:39:54 PM

Document Has Been Signed on 11/15/2022 01:39 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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:SALAZAR, SUSANFACILITY NUMBER:
304314099
ADMINISTRATOR:SALAZAR, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 396-3161
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/15/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:ApplicantTIME COMPLETED:
02:15 PM
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Licensing Program Analyst (LPA) Mahnaz (Nancy) Malek conducted an announced follow up pre licensing inspection to check on the body of water (swimming pool in the back yard) and obtain some missing documents. This is a single one story family home which day care is the dinning area. The applicant has designated the side patio area for outdoor activity for children's usage. The pool is located on the back yard adjacent to the patio.
On the previous pre licensing inspection date of 11/10/22 , the swimming pool gate located on the backyard was tested. LPA observed the gate was not self latched properly. The applicant agreed to make the following corrections:
1- Repair of the gate of the swimming pool so it works self latched properly.
2- Installation of an alarm device on the sliding door leading to back yard and patio.
3- Wooden tall shelf in the children's area shall be secured to the wall.
4- TB clearance for one adult resident.
5- Mandated Reporter Training Certificate. You can obtain it at www.mandatedreporterca.com
Today, LPA observed the gate of the swimming pool which is all mesh fenced with at least 5 feet high is self latching properly against the pool entrance. An alarm device has been installed on the pool gate for extra caution. An alarm has been installed on the sliding door leading to back yard and patio. A baby gate has been installed between the pool area and patio. An alarm is installed on the sliding door of the master bedroom leading to back yard. The master bedroom is in off limit area and has child proof door knob on it. The wooden shelf is secured to the wall. TB clearance for one adult and Mandated Reporter Training Certificate were submitted to LPA on this inspection date.
Facility is now in compliance with the requirements for Family Child Care home Title 22 Regulations. A license for a Large family childcare home will be issued after final review and management approval.
Appeal Rights were discussed and given to applicant during exit interview with applicant, Susan Salazar.
End of report.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Mahnaz Malek
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2022
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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