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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376625142
Report Date: 12/13/2023
Date Signed: 12/13/2023 09:37:00 AM

Document Has Been Signed on 12/13/2023 09:37 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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:IRIARTE, GLADYS FAMILY CHILD CAREFACILITY NUMBER:
376625142
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 6CENSUS: 6DATE:
12/13/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Gladys IriarteTIME COMPLETED:
09:50 AM
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On 12/13/2023 @ 9:00AM, Licensing Program Analyst (LPA) Nancy Diaz conducted an unannounced case management inspection in reference to Mrs. Iriarte's request for an increase of capacity. Fire clearance was received on 11/30/2023 from the San Diego Fire Prevention Bureau, granting capacity increase to 14 children.

Tour of the home was conducted with Mrs. Iriarte. Observed present today were 6 children. There were no children under age two. Also present today was Mr. Pablo Tolentino (licensee's spouse). Mr. Tolentino has completed the required Mandated Reporter Training. He also completed a Pediatric CPR/First Aid Training that is valid thru January 2025. Mr. Tolentino also has the required immunization record on file.

Facility conducted a fire drill on 10/23/2023. Mrs. Iriarte stated that she does not maintain weapons in the home. There were no bodies of water observed within the premises. Mrs. Iriarte stated that there is a complex swimming pool located 2 blocks across the street. Mrs. Iriarte stated that the pool has proper fencing. Day care children are not allowed in the pool area. Landlord consent was observed on file at the facility.

No deficiencies cited today. Increase of capacity is granted effective today, 12/13/2023.

Exit interview was conducted with Mrs. Iriarte. Licensing report was reviewed with the licensee. Copy of this report and Notice of Site visit were also given.
SUPERVISORS NAME: Joelle Redding
LICENSING EVALUATOR NAME: Nancy Diaz
LICENSING EVALUATOR SIGNATURE: DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2023
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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