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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101546
Report Date: 07/06/2023
Date Signed: 07/06/2023 11:45:02 AM

Document Has Been Signed on 07/06/2023 11:45 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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MONDRAGON, BEATRIZ FAMILY CHILD CAREFACILITY NUMBER:
376101546
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
07/06/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Applicant/Licensee Beatriz MondragonTIME COMPLETED:
11:55 AM
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On 7/6/2023 @ 11:10 a.m., Licensing Program Analyst (LPA) Joelle Redding conducted an announced comprehensive visit for the purpose of a change of location, prelicensing inspection.

Applicant presented evidence of control of property/lease agreement. LPA confirmed with that all adults living in the home have been fingerprint cleared and associated with the facility and have met all the immunization requirements. Applicant has provided evidence of a current EMSA certified First Aid/CPR and AB 1207 Mandated Reporter Training certificate.
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Because the Applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the Applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

A tour of the home was conducted. The home is one story with two bedrooms, two bathrooms and a one-car garage with the front and back yard fenced. The following areas will be used for child care: Main living room, kitchen for eating, one bedroom, both bathrooms and both yards. Off limit areas include: Master bedroom and garage. These areas will be made inaccessible while day care children are present in the home. Applicant /Licensee has been informed that all items that indicate "keep out of reach of children" are to be made inaccessible and there are no toxics, poisons or other hazardous items noted during this visit. The dual smoke detector/carbon monoxide detectors (located in each room) are operational. The fire extinguisher Licensee had today was the smaller size. She will replace with a larger - 2A10BC, later today and send a photo to LPA for verification. LPA discussed safe sleep and Incidental Medical Services during the annual visit at the prior location on 12/8/2022. A brief revisit was conducted today. Child care roster is current.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: MONDRAGON, BEATRIZ FAMILY CHILD CARE
FACILITY NUMBER: 376101546
VISIT DATE: 07/06/2023
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On this date, 7/06/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Licensee is signed up to receive email updates and information from Community Care Licensing.

Exit interview conducted and report was reviewed with the Licensee/Applicant.

Upon final file review, and confirmation of the correct size fire extinguisher, the change of location will be granted and a new license will be sent for posting.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Joelle Redding
LICENSING EVALUATOR SIGNATURE:

DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2023
LIC809 (FAS) - (06/04)
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