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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376618697
Report Date: 07/24/2024
Date Signed: 07/24/2024 05:15:20 PM

Document Has Been Signed on 07/24/2024 05:15 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:BARCENAS, SANDRA FAMILY CHILD CAREFACILITY NUMBER:
376618697
ADMINISTRATOR/
DIRECTOR:		SANDRA BARCENASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 222-4866
CITY:SAN DIEGOSTATE: CAZIP CODE:
92117
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
07/24/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:55 PM
MET WITH:Sandra BarcenasTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On 7/24/24 at 3:55 PM Licensed Program Analyst (LPA) Victoria Hernandez made an unannounced Case Management Visit for the purpose of providing an Amended Report for report previously delivered on 01/24/2024. LPA was granted entry after showing badge, identifying self, and disclosing nature of visit. Also present in home spouse Edgar Rangel and 3 children in care . Proper supervision and ratios were observed.
No deficiencies cited.

Exit interview conducted and report was reviewed with the licensee Sandra Barcenas.

A notice of site visit was given to licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days..
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Victoria Hernandez
LICENSING EVALUATOR SIGNATURE: DATE: 07/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/24/2024
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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