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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 374845100
Report Date: 06/27/2022
Date Signed: 06/27/2022 04:49:52 PM

Document Has Been Signed on 06/27/2022 04:49 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 STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:CUARENTA FAMILY CHILD CAREFACILITY NUMBER:
374845100
ADMINISTRATOR:CUARENTA,ADRIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 546-4104
CITY:ESCONDIDOSTATE: CAZIP CODE:
92026
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 7DATE:
06/27/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:20 PM
MET WITH:Licensee, Adriana CuarentaTIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analysts, Linda Almaraz and Sumayya Habeebulla arrived to the facility for another reason and noted another situation. LPAs observed a highchair without its original padding and safety straps. Per Licensee, she uses the chair in that manner because its easier to clean and feels the children are safe without the straps. Warning label on the highchair states the straps are needed until the child can sit and remove themselves on their own. Per Licensee, a child who is 2 was using the highchair.

SEE DEFICIENCY CITED DURING THIS VISIT (LIC 809D).

An exit interview was conducted and a copy of the report was given to the Licensee
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Linda M Almaraz
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 06/27/2022 04:49 PM - It Cannot Be Edited


Created By: Linda M Almaraz On 06/27/2022 at 04:22 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 STREET, STE 700
RIVERSIDE, CA 92501

FACILITY NAME: CUARENTA FAMILY CHILD CARE
FACILITY NUMBER: 374845100

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/01/2022
Section Cited
CCR
102417(d)

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102417 Operation of a Family Child Care Home (d) The home shall provide safe toys, play equipment and materials.
This requirement was not met as evidence by: Based on observation
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Licensee shall obtain original padding and straps for the highchair or remove the chair from the permises. Licensee will send a signed writtent statement ackonwleding she will use all ...
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and Licensee's own admission, she removed the padding and straps from the highchair and uses it that way. Licensee states she also uses the highchair seat on the floor rather than in chair per warning label.
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 toys, equipment and materials per the manufactures label and/or instructions, and send to LPA by POC due date.

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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:Carlos Martinez
LICENSING EVALUATOR NAME:Linda M Almaraz
LICENSING EVALUATOR SIGNATURE:
DATE: 06/27/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/27/2022


LIC809 (FAS) - (06/04)
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