376630322-9-29-2026-20-CC-SSFE-DYDQAF-20260929115953

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376630322
Report Date: 09/29/2026
Date Signed: 09/29/2026 12:00:08 PM

Document Has Been Signed on 09/29/2026 12:00 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	ANDRAL, EDNER FAMILY CHILD CARE		FACILITY NUMBER:	376630322
ADMINISTRATOR/ DIRECTOR:	EDNER ANDRAL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 717-4099
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 17	CENSUS: 2	DATE:	09/29/2026
TYPE OF VISIT:	POC	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:05 AM
MET WITH:	Edner Andral		TIME VISIT/ INSPECTION COMPLETED:	12:15 PM

NARRATIVE

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On September 29,2026, at 9:05 AM., Licensing Program Analyst (LPA), Saray Siqueiros-Frayre conducted an unannounced Plan of Correction (POC) inspection. The purpose of this inspection is to ensure that the deficiencies cited on September 4, 2026, have been corrected. LPA discussed the purpose of the inspection and was granted entry into the facility. LPA was accompanied by licensee to tour the facility. Also present at the facility was licensee's assistant, Osna Utervil and two (2) day care children, one (1) of whom was under twenty-four (24) months old. LPA obtained a copy of current facility roster during the inspection.

The following deficiencies have been corrected as follows:

- On September 29, 2026, LPA observed and tested the carbon monoxide detector in the facility and determined to be operational.

- On September 20, 2026, licensee submitted copies of the safe sleep log for one of the infants in care. On September 29, 2026, licensee provided copies of the safe sleep logs for the additional two infants in care.

- On September 29, 2026, licensee provided proof of appointment confirmation for licensee’s assistant to obtain pediatric First Aid and CPR certification. Appointment is scheduled for October 11, 2026, from 9:00 AM to 5:30 PM.

- On September 29, 2026, licensee provided copies of personnel records for assistant. Assistant provided proof of Preventative Health Practices appointment scheduled for October 11, 2026.

Tulam Vu
Saray Siqueiros-Frayre
	DATE: 09/29/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ANDRAL, EDNER FAMILY CHILD CARE	FACILITY NUMBER: 376630322
	VISIT DATE: 09/29/2026

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-On September 29, 2026, LPA conducted a review of the children’s records and observed that each child’s file contained a copy of the child’s immunization records.

- On September 29, 2026, LPA conducted a review of the children’s records and observed that each child’s file contained a complete and signed Identification and Emergency Information (LIC700) form.

- On September 29, 2026, LPA conducted a review of the children’s records and observed that each child’s file contained a complete and signed Notification of Parent’s Rights (LIC 995A) form.

- On September 29, 2026, LPA conducted a review of the children’s records and observed that each child’s file contained a complete and signed Affidavit Regarding Liability Insurance (LIC 282) form.

During the inspection, licensee stated that he understands that assistant cannot be left alone with day care children until pediatric First Aid and CPR certifications are completed. Licensee stated that he will ensure that assistant is not left alone with children in care and that assistant will accompany him during children pick-up and drop-offs until certification is obtained. LPA provided licensee with a copy of personnel requirement.

All deficiencies cited on September 4, 2026, have been cleared.

LPA provided licensee with copies of Letter of Deficiencies Citation Cleared.

Notice of Site visit was given and must remain posted for 30 days. Exit interview was conducted and this report was reviewed with Licensee, Edner Andral.

NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Saray Siqueiros-Frayre
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/29/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2026

LIC809 (FAS) - (06/04)

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