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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629448
Report Date: 04/28/2023
Date Signed: 04/28/2023 09:55:01 AM

Document Has Been Signed on 04/28/2023 09:55 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:RODRIGUEZ, ELENA FAMILY CHILD CAREFACILITY NUMBER:
376629448
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
04/28/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Elena RodriguezTIME COMPLETED:
10:00 AM
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On 4/28/23 at 9:00 am, Licensing Program Analyst (LPA) Adrian Castellon conducted an announced capacity increase inspection with licensee Elena Rodriguez. Purpose of the visit is to ensure that facility is in compliance so that a large license capacity 14 may be issued A fire clearance report dated 04/26/21 was received by the SDRO. Licensee Rodriguez will use the following areas for child care: living room, dining area, daycare room and hallway bathroom. Off limits areas include: all bedrooms which are properly secured. Licensee will utilize the fully fenced back yard for outdoor activities. There are no bodies of water observed during time of visit. Licensee states that there are no firearms in the home. The fire extinguisher, carbon monoxide detector and smoke detector meet requirements and are operational. A fire extinguisher has been installed as required by the Chula Vista Fire Department.

LPA Castellon reviewed children's

A large license may be issued after a final file review. No citations issued on this date.

SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2023
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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