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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629321
Report Date: 04/29/2022
Date Signed: 05/04/2022 02:42:43 PM

Document Has Been Signed on 05/04/2022 02:42 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:CERVANTES, DIANA FAMILY CHILD CAREFACILITY NUMBER:
376629321
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/29/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Diana CervantesTIME COMPLETED:
01:30 PM
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On 4/29/22 at 1:00pm, Licensing Program Analyst (LPA) Cindy Meier conducted an announced Pre-licensing inspection with applicant, Diana Cervantes. The purpose of the inspection is to ensure the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This one story, four bedroom, two bath home was toured and inspected. The hours of operation are Monday through Saturday, 6:00 a.m. to 12:00 a.m.

Upon arrival LPA observed the home was under construction which included scaffolding, black wrap paper and chicken wire in the front and back areas. LPA also observed scaffolding and electrical wiring hanging from the rafters in the back play yard.

The LPA informed the applicant that the home could not be approved for a licensee at this time as the construction and equipment poses a risk to the health and safety of the children in care.

Applicant will inform LPA when the construction is complete and LPA will schedule another Pre-Licensing inspection.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Cindy Meier
LICENSING EVALUATOR SIGNATURE: DATE: 04/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/29/2022
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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