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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629162
Report Date: 11/29/2022
Date Signed: 11/29/2022 12:23:03 PM

Document Has Been Signed on 11/29/2022 12:23 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, KEYLLY FAMILY CHILD CAREFACILITY NUMBER:
376629162
ADMINISTRATOR:KEYLLY MIRANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 246-3719
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 5DATE:
11/29/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Keylly MirandaTIME COMPLETED:
12:30 PM
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On 11/29/22 at 11:00AM, LPA Luigi Gargaro conducted an unannounced case management inspection visit to the facility. Visit was conducted as licensee is rearranging the set up of her home converting previous off limits areas to either for use or child proofed pass through areas. Analyst met with licensee Keylly Miranda during today's visit and toured and inspected the home to review the anticipated set up.

Licensee advised analyst that previous off limits areas, the kitchen and designated room #1, will now be open to the day care. The kitchen, which was off limits before with an installed safety gate at its entrance, will now be primarily used as a pass through area to provide access from now for use room #1 to the rest of the home. The kitchen was inspected today and found to be safely child proofed and available for immediate use.

Room #1, which was previously off limits as it was behind the off limits kitchen, will now be used as the primary day care room. Room #1 was inspected today and found to be safely child proofed and appropriately furnished for day care and also available for immediate use.

The previously remaining for use areas, the living room, the second bedroom (room #2) and the home bathroom, will continue to be designated as such. The living room will not be a primary day care room but can be used at the licensee's discretion if needed for any additional activities and as a pass through room to the bathroom and room #2. The third bedroom (room #3) and the garage (whose home entrance is in room #1 and is made off limits with a locking door handle) will now be the only off limits areas in the home.

Licensee provided analyst with a new facility sketch during today's visit reflecting the new floor plan and posted a copy of the new plan in her posting area. The changes in for use and off limits rooms are approved effective for use today. Today's report was reviewed with Ms. Miranda and a copy signed for and provided to her for her records.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
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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