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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100964
Report Date: 02/07/2022
Date Signed: 02/07/2022 02:18:28 PM

Document Has Been Signed on 02/07/2022 02:18 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:BAUTISTA, TERESA FAMILY CHILD CAREFACILITY NUMBER:
376100964
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
02/07/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Teresa Bautista TIME COMPLETED:
02:30 PM
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On 2/7/22 at 2:00pm Licensing Program Analysts (LPAs) Annette Sutherland and Selina Siao conducted a pre- licensing follow-up inspection. LPAs met with Teresa Bautista also present was one infant day care child. The purpose of today's inspection is to ensure the pool fencing meets the department requirements. Applicant has extended the fencing to be over 5 feet high. There is a self-latching gate that swings away from the pool and the latch meets the department's requirement.

The home also has a window that has access to the pool and there is sufficient space to place a fence therefore Applicant has placed a fence to block off the window. Pool fencing now meets all regulatory requirements.

No corrections are needed. A license for 8 children may be granted upon final file review. Applicant agreed to comply with all regulations and laws governing family child-care homes. This report was translated to applicant in Spanish for todays inspection.

An exit interview was conducted with applicant. Applicant was provided a copy of the report (LIC809) and their signature on this form acknowledges receipt of these rights.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 02/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/07/2022
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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