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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629265
Report Date: 05/18/2022
Date Signed: 05/18/2022 09:53:52 AM

Document Has Been Signed on 05/18/2022 09:53 AM - 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:KAROLI, ERICK FAMILY CHILD CAREFACILITY NUMBER:
376629265
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
05/18/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Erick KaroliTIME COMPLETED:
10:10 AM
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On 05/18/2022, at 9:00AM Licensing Program Analysts (LPAs) David Miller and Martha Malane conducted a second pre-licensing inspection with applicant, Erick Karoli. The purpose of the inspection is to inspect the newly installed fence that separates the backyard (off limits area) from the patio as well as follow-up on verifying that all new adults residing in the home have received criminal record clearances.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Applicant was also reminded to report to the Department by telephone or fax within the Department’s next business day and during normal working hours (8am to 5pm) of any change in household composition including adults moving in or out of the home and anyone living in the home who reaches his or her 18th birthday.

LPA conducted an inspection of the backyard and took photographs of the fence separating the patio from the backyard.

LPA discussed the maximum capacity for a small family child care home: four infants only (infants mean any children under 24 months); or six children with no more than three infants; or, with landlord consent, eight children with no more than two infants, one child in kindergarten or elementary school and one child at least age six, including children under age 10 who live in the home.

A small license is granted effective today, 05/18/2022. An exit interview was conducted and a review of the report was discussed with the applicant, Erick Karoli.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: David Miller
LICENSING EVALUATOR SIGNATURE: DATE: 05/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/18/2022
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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