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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364819289
Report Date: 09/17/2021
Date Signed: 09/17/2021 01:38:35 PM

Document Has Been Signed on 09/17/2021 01:38 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:GRANADOS FAMILY CHILD CAREFACILITY NUMBER:
364819289
ADMINISTRATOR:GRANADOS, LIDIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 562-4238
CITY:RIALTOSTATE: CAZIP CODE:
92376
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
09/17/2021
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:18 PM
MET WITH:Lidia Granados, Licensee
Astrid Granados, Assistant		TIME COMPLETED:
01:37 PM
NARRATIVE
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Translated in Spanish to the Licensee by Astrid (Assistant)

Licensing Program Analysts(LPA) Elyse Jones arrived at the facility to conduct a Case Management inspection for the purpose of addressing separate matters that were discovered during an inspection at the facility. During the inspection LPA conducted a tour of the facility and census were taken. During record review it was discovered the facility did not have a completed roster and files were missing for C1 and C2.

See LIC 809-D for deficiency cited

An exit interview was conducted with the facility Licensee. Notice of Site Visit was left with the Licensee and must be posted for 30 days.

A copy of the report was left at the facility and must be made available to the public for three years upon request.

SUPERVISORS NAME: Aaron Ross
LICENSING EVALUATOR NAME: Elyse Jones
LICENSING EVALUATOR SIGNATURE: DATE: 09/17/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/17/2021
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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Document Has Been Signed on 09/17/2021 01:38 PM - It Cannot Be Edited


Created By: Elyse Jones On 09/17/2021 at 01:18 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: GRANADOS FAMILY CHILD CARE
FACILITY NUMBER: 364819289

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2021
Section Cited
CCR
102421(a)

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Child's Records 102421(a)
The licensee shall maintain, in each child's record, the signed and dated notice form required in Section 102419(d). The requirement was not met as evidenced by:
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Licensee agrees to ensure all children enrolled have a completed file with required Licensing documents.

C1 and C2 are no longer enrolled.
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Based on the interview and record review the Licensee did not meet Childs Records which poses an potential Health, Safety & Personal Rights risk to the children in care. Assistant stated there are no records available for review for C1 and C2.
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Type B
09/17/2021
Section Cited
CCR102417(g)(8)

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Operation of a Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not as evidenced by:
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Licensee agrees to submit a completed roster to the Department by COB on 9-17-2021. Licensee also agrees to ensure the roster is completely filled out in the future with all chidlren enrolled.
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Based on the interview and record review the Licensee did not meet Childs Records which poses an potential Health, Safety & Personal Rights risk to the children in care. Assistant stated there is not a completed roster available for review.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Aaron Ross
LICENSING EVALUATOR NAME:Elyse Jones
LICENSING EVALUATOR SIGNATURE:
DATE: 09/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/17/2021


LIC809 (FAS) - (06/04)
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