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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610382
Report Date: 03/23/2021
Date Signed: 03/23/2021 01:32:17 PM

Document Has Been Signed on 03/23/2021 01:32 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:CARLON, BLANCA FAMILY CHILD CAREFACILITY NUMBER:
136610382
ADMINISTRATOR:BLANCA CARLONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 540-5854
CITY:BRAWLEYSTATE: CAZIP CODE:
92227
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
03/23/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Blanca CarlonTIME COMPLETED:
01:30 PM
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On March 23, 2021 Licensing Program Analyst, (LPA), Gloria Gonzalez conducted an unannounced case management inspection, that was initiated by Licensee, Blanca Carlon via video conference by Face Time, due to the Covid-19 state of emergency.  LPA disclosed the purpose of today's inspection which is to inspect bathroom 3 to be used for childcare use and was granted a video tour into the facility by the Licensee. Licensee stated that there are no children in care and Licensee during the inspection. This is a 3 bedroom, 3 bath single story home.  Areas which may be used for childcare are: kitchen, dining room, living room, daycare room, bathroom #3, and backyard. Off-limit areas are:  bedrooms  2, 3, master, master bathroom, hallway bathroom, and storage area. They are made inaccessible to day care children through the use of doorknob covers. The Licensee will utilize the backyard for outdoor activities for the children. LPA inspected the new bathroom 3 that was previously used as a laundry room. LPA did not notice any hazards in the bathroom #3 and is approved for day care use effective today.

No deficiencies cited.

LPA Gloria Gonzalez interpreted and explained the inspection report to applicant, applicant stated she understood. 

A copy of the report, appeal rights (LIC 9058), and Notice of Site Visit (LIC9213) will be e-mailed to the Licensee and Licensee was advised that acknowledgement of the receipts of the report and appeal rights are to be received within twenty-four hours.

An exit interview was conducted.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2021
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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