<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628585
Report Date: 09/16/2021
Date Signed: 09/16/2021 03:18:51 PM

Document Has Been Signed on 09/16/2021 03:18 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:LAGRONE-WHITE, VERA FAMILY CHILD CAREFACILITY NUMBER:
376628585
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
09/16/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Vera Lagrone-White, LicenseeTIME COMPLETED:
03:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 09/16/2021, at 2:45 p.m., Licensing Program Analyst (LPA), Michelle Hood conducted an unannounced case management inspection with licensee. LPA notified licensee the purpose of the inspection was for a change of capacity and the licensee led LPA on a tour of the facility. There were three (3) children present at the time of the inspection.

On 09/16/2021, a fire clearance was approved for 14 children. The following areas used for child care: daycare room, hallway bathroom, living room and backyard. The off limits areas are made inaccessible through use of safety gates and door knob covers. The living room fireplace and stairs are barricaded. There are no bodies of water observed during time of inspection. There is a sufficient amount of age appropriate toys, games, and books available. The home was clean and orderly during inspection. The fire extinguisher, smoke alarm and carbon monoxide detector are operational. There is a working telephone in the home and all required forms are posted. Licensee stated that there are NO firearms or ammunition on the property. All adults living or working in the home have been fingerprint cleared and associated. LPA reviewed emergency drill log. Pediatric CPR and First Aid certification expire 05/2022. LPA discussed with Licensee maintaining supervision of day children at all times. LPA reviewed the following with licensee: SIDS, car seat law, reporting requirements, shaken baby syndrome and care and supervision. Licensee was also reminded the following items are prohibited during day care operating hours (walkers, exersaucers, jumpers and bouncy seats). Corporal punishment and smoking are not allowed in the day care. Incidental Medical Services (IMS) policy was discussed.

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 is no Qualified Assistant, 14 years of age or present, the capacity reverts back to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 09/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/16/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: LAGRONE-WHITE, VERA FAMILY CHILD CARE
FACILITY NUMBER: 376628585
VISIT DATE: 09/16/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
A copy of the case management report, Notice of Site Visit – LIC 9213 and appeal rights (LIC 9058) will be e-mailed to the licensee and the licensee was advised that acknowledgement of receipt of the report and appeal rights are to be received within twenty-four hours. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

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: 09/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021
LIC809 (FAS) - (06/04)
Page: 2 of 2