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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629122
Report Date: 08/02/2021
Date Signed: 08/02/2021 06:27:18 PM

Document Has Been Signed on 08/02/2021 06:27 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:ESTRADA, SARAI FAMILY CHILD CAREFACILITY NUMBER:
376629122
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/02/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Sarai EstradaTIME COMPLETED:
06:30 PM
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On 08/02/21 at 4:00PM, LPA, Luigi Gargaro, conducted an announced prelicensing inspection with the applicant. The purpose of the visit is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and combination smoke and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Analyst inquired if there are any bodies of water or weapons in the home and the applicant replied no. A review of records on this date indicates that all adults or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. Applicant rents the home and previously provided proof of control of property, in the form of a lease agreement, to analyst. First Aid and CPR expire on 06/11/23.

Applicant will be using the following rooms for childcare: the back day care room and the day care restroom. While the kitchen, dining area and living room are also open to the day care and were inspected today and found to be satisfactorily child proofed, applicant states they will have limited use in the facility but can be used at the applicant's discretion. The following areas will be off limits: the two home bedrooms. The bedrooms are made off limits with door knob covers that are installed on the respective entry door's handles. The applicant does have a laundry area that analyst reviewed and found to be safely child proofed with latched equipment and all cleansers and detergents stored on high inaccessible shelves. The applicant also has an off limits studio home where her cleared and associated tenant, Fabian Orozco, resides. The studio is made off limits with a locking door handle. The applicant has sufficient toys and equipment available. The home has a fenced small back patio area and backyard available for outdoor activities. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2021
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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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: ESTRADA, SARAI FAMILY CHILD CARE
FACILITY NUMBER: 376629122
VISIT DATE: 08/02/2021
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When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA and applicant discussed California Megan's Law and he provided applicant with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis.

The new provider packet was reviewed with the applicant including information on child abuse reporting, children’s records, immunizations, adults living or working in the home, shaken baby syndrome, SIDS, and the YMCA Resource Center. Applicant was reminded that corporal punishment, smoking, walkers, exersaucers, jumpers and bouncy seats are not allowed in day care.

No corrections are needed, a license for 8 will be issued effective today. Community Care Licensing web site: http://ccld.ca.gov
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021
LIC809 (FAS) - (06/04)
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