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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376627257
Report Date: 09/06/2022
Date Signed: 09/06/2022 02:40:56 PM

Document Has Been Signed on 09/06/2022 02:40 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:BAHENA, PATRICIA FAMILY CHILD CAREFACILITY NUMBER:
376627257
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
09/06/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Bahena, Patricia LicenseeTIME COMPLETED:
10:50 AM
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On 09/06/2022 at 10:30 am, Licensing Program Analyst (LPA), Michelle Hood conducted an unannounced Case Management Inspection and met with the Licensee Patricia Bahena. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. There were two daycare children and two foster children present in the facility during this inspection. The licensee accompanied LPA inside and out of the facility during this inspection. The off-limits areas are inaccessible through the use of door locks and safety gates.

On 08/23/2022, a fire clearance was approved for 14 children. LPA discussed with the licensee, the maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there are no Qualified Assistants, 14 years of age or present, the capacity reverts back to the requirements for a Small Family Child Care. The licensee stated she understands. LPA provided the licensee with the large capacity worksheet. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

An exit interview was conducted and the report was reviewed with the licensee Patricia Bahena. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited.

A Regular Large Family Child Care Home license may be issued for 14 children upon final file review.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2022
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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