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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376621421
Report Date: 06/02/2022
Date Signed: 06/02/2022 10:29:16 AM

Document Has Been Signed on 06/02/2022 10:29 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:DURAZO, CARLA FAMILY CHILD CAREFACILITY NUMBER:
376621421
ADMINISTRATOR:CARLA R. DURAZOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 421-2492
CITY:CHULA VISTASTATE: CAZIP CODE:
91914
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 4DATE:
06/02/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Carla DurazoTIME COMPLETED:
10:45 AM
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On June 2, 2022 at 9:30 am, Licensing Program Analyst, (LPA), Gloria Gonzalez conducted an unannounced Plan of Correction (POC) inspection at the facility. Purpose of this inspection is to ensure citations issued during an annual inspection dated 5/31/22 were corrected. Upon arrival, LPA met with Licensee, Carla Durazo and proceeded to tour the facility.

LPA observed four (4) daycare children (2 infants and 2 toddlers), and one (1) assistant during this inspection.

The following citations issued on 5/31/22 were corrected as follows:

Staffing ratio and capacity: Licensee has corrected this citation by having 2 infants in her care on this date which is within regulation.

Criminal Record Clearance: Licensee has corrected this citation by submitting the completed LIC 9163 Live Scan form for Adult #1 on 6/1/22.

The citation for mandated reporter training certificate POC is due by 6/14/22.

The citation for TB clearance for Adult #1 POC is due by 6/7/22.

No deficiencies cited.

LPA interpreted and explained the inspection report to licensee, licensee stated she understood.

LPA provided Licensee, Carla Durazo with the Notice of Site Visit – LIC 9213. LPA observed form LIC 9213 posted on the bulletin board at the entrance and advised this form is to remain posted for thirty (30) days. An exit interview was conducted with the licensee, who was provided a copy of their Licensee Appeal Rights (LIC 9058 1/16).
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 06/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/02/2022
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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