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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628634
Report Date: 10/08/2021
Date Signed: 10/08/2021 04:27:24 PM

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:AJA MAZA, NATALIA FAMILY CHILD CAREFACILITY NUMBER:
376628634
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
10/08/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Natalia Aja MazaTIME COMPLETED:
11:00 AM
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On 10/8/2021 at 10:40am, Licensing Program Analyst (LPA), Martha Malane conducted an unannounced increase in capacity inspection at the facility. Upon arrival, LPA met with Licensee, Natalia Aja Maza and proceeded to tour the facility. There were four (4) children present during today’s inspection.

The following areas are used for child care: living room, kitchen, bathroom, bedroom #2 and front yard. Off limits areas are bedroom #1 and side yard which are inaccessible through use of latches, locks and door locks.

A fire clearance for 14 children was granted on 8/12/2021.

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 no qualified assistant, 14 years of age or older is present, the capacity reverts back to the requirements for a Small Family Child Care. LPA and licensee discussed qualifications for an assistant.

To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

An exit interview was conducted with Licensee, Natalia Aja Maza and a copy of this report, Notice of Site Visit and appeal rights were provided.

A large license for 14 children is granted effective today, 10/8/2021.
SUPERVISOR'S NAME: Tulam VuTELEPHONE: (619) 767-2212
LICENSING EVALUATOR NAME: Martha MalaneTELEPHONE: (619) 767-2231
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2021
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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