<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376621741
Report Date: 09/15/2023
Date Signed: 09/15/2023 10:34:14 AM

Document Has Been Signed on 09/15/2023 10:34 AM - 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:SALCEDO, BERTHA FAMILY CHILD CAREFACILITY NUMBER:
376621741
ADMINISTRATOR:BERTHA SALCEDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 267-9852
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 1DATE:
09/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Bertha SalcedoTIME COMPLETED:
08:40 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On September 15th, 2023, at 8:20 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted a case management inspection regarding a potential violation observed during a complaint investigation. LPA advised Licensee Bertha Salcedo of the visit’s meeting and granted LPA facility entry. Present in the home was the Licensee and one (1) child; during this inspection one (1) helper arrived. Language Link Operator 16336 provided Spanish language translation.

Licensee provided the Department with the June 2023 time sheets. The Licensee agrees to provide the Department with a written statement describing the total number of children physically present in the daycare on 06/15/2023 from 8 AM to 2:20 PM by 10/02/2023.

Notice of site visit was given to the licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Licensee/Appeal Rights (LIC 9058) was provided to the licensee. Exit interview conducted and report was reviewed with the Licensee Bertha Salcedo.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 09/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/15/2023
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 1