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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304314294
Report Date: 07/05/2024
Date Signed: 07/05/2024 10:57:43 AM

Document Has Been Signed on 07/05/2024 10:57 AM - 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 COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:GUERRERO, LUCYFACILITY NUMBER:
304314294
ADMINISTRATOR/
DIRECTOR:		G. NUBIA & G. LUCYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 822-5131
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
07/05/2024
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:00 AM
MET WITH:Applicant, Lucy GuerreroTIME VISIT/
INSPECTION COMPLETED:
09:00 AM
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On 7/5/24, Licensing Program Analyst (LPA) Sun conducted a visit to follow up on the corrections noted on the pre-licensing visit conducted on 5/17/24. LPA met with Applicant, Lucy Guerrero and toured the facility. Present during the visit was applicant and assistant.

During today’s inspection, LPA observed the swimming pool was completely surrounded by a mesh fence and the mesh fence is 5 feet and 1 inch high. The mesh fence surrounding swimming pool is 7 feet away from the master bedroom window. LPA confirmed no window or door provides direct access to the pool.

After the tour of the home, the facility met all licensing requirement, and the file will be submitted to the manager for final approval.

In the event additional requirements are needed, the applicant will be notified. A license will be issued once all requirements are met.

Exit interview conducted and report was reviewed with applicants Lucy Guerrero in Spanish. Appeal rights were provided.


End of Report.
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 07/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/05/2024
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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