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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101548
Report Date: 08/30/2023
Date Signed: 08/30/2023 09:00:20 AM

Document Has Been Signed on 08/30/2023 09:00 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:AZRIA, HELEN FAMILY CHILD CAREFACILITY NUMBER:
376101548
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/30/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Helen AzriaTIME COMPLETED:
09:15 AM
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On 8/30/23 @ 8:35AM, Licensing Program Analyst (LPA) Nancy Diaz conducted an announced follow-up prelicensing inspection with applicant Helen Azria. The purpose of this inspection is to observe corrections as requested on 8/17/23.

The following corrections were observed today:

1. Applicant cleared the front lawn and removed pesticide container and construction materials.
2. A barricade was installed to make the laundry area inaccessible to children.
3. Applicant obtained a firm mattress for the play pen for infant to sleep in.
4. Applicant cleared the back yard and remove cans of paint, pesticide container and construction materials.
5. Applicant installed a barricade to make the stairs in the yard inaccessible to children.
6. Storage of weapon and ammunition were observed today. The weapon and ammunition were observed stored and locked separately.

A license for a small family child care home is granted today, 8/30/2023.

Exit interview was conducted with Helen Azria (applicant). LPA reviewed the report and provided a copy today.
SUPERVISORS NAME: Tashima Daniel
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/30/2023
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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