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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100588
Report Date: 07/20/2022
Date Signed: 07/20/2022 04:48:23 PM

Document Has Been Signed on 07/20/2022 04:48 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:VILLALOBOS, SYLVIA FAMILY CHILD CAREFACILITY NUMBER:
376100588
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 3CENSUS: 1DATE:
07/20/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Sylvia VillalobosTIME COMPLETED:
04:50 PM
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On 7/20/22, Licensing Program Analyst (LPA), Tyra Block, made an unannounced Case Management- Licensee Initiated visit for the purpose of inspecting the home for a capacity increase to ensure the licensee remains in substantial compliance with the health & safety standards as required by regulations governing family child care homes. LPA met with Sylvia Villaobos. Present at the home with licensee was 1 infant. All adults had criminal background clearances and were associated to the facility, except for licensee's daughter who recently returned from college. Fingerprints have been submitted and pending clearance.
Home was inspected by fire department and fire clearance was granted on 6/21/22. The home appears to have adequate space to accommodate 14 children. There were no hazards observed. Poisons and chemicals are inaccessible to children. The carbon monoxide and smoke detector are operational. There is a fire extinguisher (3A40BC) available, first aid kit, and activities available for children. The fenced backyard is available for outdoor activities.
The areas used for child care are: Daycare Room, Infant Room, Living Room, Hall Bathroom, and Dining Room.
Required postings were posted, including COVID-19 posters. CPR/ First Aid certification is current (exp. 6/24), mandated reporter training is to be renewed 1/2024 . Licensee is reminded that children are not allowed in off-limit areas and no changes should be made to the property without notifying and receiving approval from child care licensing. Licensee was also reminded to contact LPA or the duty line within 24 hours of any unusual injury or incident followed by completing LIC 624B. Licensee was also reminded disaster drills must be conducted and logged at least every 6 months.
No deficiencies are cited. No corrections are needed; a license for 14 will be issued effective today.
MAX. CAP (WHEN THERE IS AN ASSISTANT PRESENT): 12 - NO MORE THAN
4 INFANTS. CAP 14 - NO MORE THAN 3 INFANTS. 1 CHILD IN
KINDERGARTEN OR ELEMENTARY SCHOOL AND 1 CHILD AT LEAST AGE 6.

An exit interview was conducted with licensee, Sylvia Villalobos. A Notice of Site Visit was provided and must be posted for 30 days.

SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Tyra Block
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2022
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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