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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629141
Report Date: 07/12/2021
Date Signed: 07/14/2021 02:18:53 PM

Document Has Been Signed on 07/14/2021 02:18 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:MIRANDA, CHERISH FAMILY CHILD CAREFACILITY NUMBER:
376629141
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
07/12/2021
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Cherish MirandaTIME COMPLETED:
05:00 PM
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On 07/12/21 at 3:30pm, Licensing Program Analyst (LPA) Adrian Castellon conducted an announced Pre-Licensing inspection with applicant, Cherish Miranda. Purpose of the visit is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3. Applicant Miranda recently submitted a change of location application. This 3 bedroom, 2 bath home was toured and inspected to ensure an environment safe for the care and supervision of children. Applicant is renting the home from a family member the facility and has provided proof by rental agreement. Applicant has provided LPA with a completed copy of the LIC9149, Landlord Consent allowing Applicant to operate at the full capacity of 8 children. Applicant will use the following areas for child care: living room, dining area, and hallway bathroom. Off limits areas include: garage, back patio and all bedrooms. There are no stairs in the home. Applicant will utilize fully fenced side left yard for outdoor activities. There are no bodies of water observed during time of visit. Applicant states that there are no firearms in the home. The fire extinguisher, carbon monoxide dectecor and smoke detector meet requirements and are operational. All poisons, cleaners and hazardous items in the home are inaccessible to children through latches, locks, and/or placed up on high surfaces. Children’s toys and play equipment are available. Applicant states there are no firearms or other weapons in the home. Applicant has completed the 8 hours of preventative health. Pediatric CPR and First Aid certifications expire on 12/22. Required documents are posted. Applicant applicant's boyfriend and applicant's mother are the only adults residing in the home and have been cleared for criminal record and child abuse index clearances. Applicant was advised that any new/additional adults must be cleared prior to working or residing in home. Any minor upon his/her 18th birthday must be fingerprinted within 30 days. Applicant is exempt from Mandated Reporter AB1207 training has been completed. LPA Castellon reviewed an child's folder during the inspection.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 07/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/12/2021
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: MIRANDA, CHERISH FAMILY CHILD CARE
FACILITY NUMBER: 376629141
VISIT DATE: 07/12/2021
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Applicant was advised to regularly visit the Community Care Licensing WEB SITE: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information. Duty Line was provided: (619) 767-2248. LPA's discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov


SAFE SLEEP PLAN and documentation was discussed. The provider physically checks on sleeping infants every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age and shall be available to the Department for review. The provider places infants up to 12 months of age on their backs for sleeping.

Applicant states that he will comply with all regulations and laws governing family child care homes and that she is financially secure to operate a family child care home for children. LPA reviewed this report with Applicant prior to obtaining his signature.
  • a small license of a capacity of 8 children maybe issued upon final file review.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2021
LIC809 (FAS) - (06/04)
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