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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 336300492
Report Date: 06/07/2022
Date Signed: 06/07/2022 08:55:40 AM

Document Has Been Signed on 06/07/2022 08:55 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
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:LUA FAMILY CHILD CAREFACILITY NUMBER:
336300492
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
06/07/2022
TYPE OF VISIT:POCANNOUNCEDTIME BEGAN:
08:32 AM
MET WITH:Alberta LuaTIME COMPLETED:
09:00 AM
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On 6/7/22 at 8:32AM, Licensing Program Analysts (LPAs) Jeanette Sanchez and Lorena Valenzuela arrived at the facility to conduct a pre-licensing POC inspection. Present during this inspection was applicant Alberta Lua.

LPAs verified the following corrections:

1. Child safety gate to make kitchen inaccessible
2. Child safety latch for knife drawer and cabinet which contains medicine
3. Child safety latches for hallway closets
4. Child safety latches for bathroom cabinets
5. First Aid kit
6. Parent board with: facility sketch, emergency disaster plan, parents' right poster, car seat poster and see something poster.

The pool now has a 5ft wrought iron fence with two doors. One door has a functioning self-latching mechanism, while the other door's self-latching mechanism was not functioning properly. Applicant will have the door repaired and follow up with LPA Sanchez.

Once the correction has been verified, the application for a Small Family Child Care Home will be submitted for approval with a maximum capacity of 6, or 8 with parent notification. Applicant advised that all corrections are due within 30 days or the application may be withdrawn.

Exit interview conducted and report was reviewed with the applicant Alberta Lua.
SUPERVISORS NAME: Stephanie Hudak
LICENSING EVALUATOR NAME: Jeanette Sanchez
LICENSING EVALUATOR SIGNATURE: DATE: 06/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/07/2022
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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