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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628615
Report Date: 04/28/2022
Date Signed: 04/28/2022 01:05:17 PM

Document Has Been Signed on 04/28/2022 01:05 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:HERRERA, ANDREA & KEITH FAMILY CHILD CAREFACILITY NUMBER:
376628615
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
04/28/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Andrea Herrera, LicenseeTIME COMPLETED:
01:15 PM
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On 04/28/2022 at 12:45 pm, Licensing Program Analysts (LPAs), Michelle Hood and Crystal Tillory conducted an unannounced case management inspection and met with the Licensee Andrea Herrera. LPAs disclosed the purpose of the inspection is for a pending capacity change and was granted entry into the facility by the Licensee. There were no children present in the facility during this inspection. The licensee accompanied LPAs inside and out of the facility during this inspection. The following areas used for child care are the living room (daycare room), bathroom #1 and backyard. The living room fireplace is barricaded. The off-limits areas are inaccessible through the use of door locks and safety gates.

On 01/19/2022, a pending request fire clearance was sent for 14 children. The fire extinguisher, smoke detector, and carbon monoxide detector met the requirements. All hazardous items were inaccessible to children. The facility has toys, play equipment, and materials available. The licensee was reminded all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to the 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. Licensee’s First Aid and CPR certifications expire on 04/2024. The licensee have required immunization's. The facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 02/26/2022. LPA provided and discussed the following: a large capacity. The licensee was reminded corporal punishment, smoking, exersaucers, bouncy seats, walkers, jumpers, and/or similar equipment are not allowed in daycare. LPAs and Licensee discussed California Megan's Law and LPAs provided: www.meganslaw.ca.gov.

The maximum capacity for a large family child care home: 12 children (with a qualified assistant) with no more than 4 infants; or (with landlord consent) 14 children (with a qualified assistant) with no more than 3 infants, 1 child enrolled in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. When there is no Qualified Assistant, 14 years of age or present, the capacity reverts back to the requirements for a Small Family Child Care. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2022
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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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: HERRERA, ANDREA & KEITH FAMILY CHILD CARE
FACILITY NUMBER: 376628615
VISIT DATE: 04/28/2022
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An exit interview was conducted and the report was reviewed with the licensee Andrea Herrera. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Once the fire clearance is approved, a Regular Large Family Child Care Home license may be issued for 14 children upon final file review.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
LIC809 (FAS) - (06/04)
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