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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630235
Report Date: 01/03/2025
Date Signed: 01/03/2025 11:07:02 AM

Document Has Been Signed on 01/03/2025 11:07 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:FUENTES, ADELINA FAMILY CHILD CAREFACILITY NUMBER:
376630235
ADMINISTRATOR/
DIRECTOR:		ADELINA FUENTESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 601-4036
CITY:SAN DIEGOSTATE: CAZIP CODE:
92154
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/03/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Applicant Adelina FuentesTIME VISIT/
INSPECTION COMPLETED:
11:20 AM
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On 01/03/2025 at 9:15 AM, Licensing Program Analyst (LPA) Julieta Abrego conducted an announced pre-licensing inspection for a change of location with the applicant, Adelina Fuentes. The purpose of the inspection is to ensure that the home complies with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This 3-bedroom, 2-bath home was toured and inspected to ensure the environment is safe for the care and supervision of children.
The applicant provided proof of control of the property for review by the Department. The applicant will use the following areas for childcare: living room, den, bedroom #1, bathroom #1, and backyard. Off-limits areas include bedroom #2, bedroom #3, bathroom #2, kitchen and garage. They are made inaccessible to daycare children through the use of doorknob covers, door latches and safety gates. The applicant will utilize the backyard for outdoor activities and is properly fenced. There are no bodies of water observed during the time of the visit. The applicant stated there are no weapons or firearms. LPA observed a fireplace in the Livingroom and is properly barricaded. The fire extinguisher is rated 2A 10-B:C, and smoke, and carbon monoxide detectors meet requirements and are operational. The fire department approved a fire clearance on 12/22/2024. All poisons, cleaners, and hazardous items in the home are inaccessible to children through latches, locks, and/or placed on high surfaces.

Children’s toys and play equipment are available. The applicant has completed the 8 hours of preventative health. Pediatric CPR and First Aid certifications expire on 12/2025. The applicant has completed the Mandated Reporter AB1207 training certification on 12/28/2023. Immunization records per SB792 were reviewed and are in compliance with the applicant.



Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).
SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2025
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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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: FUENTES, ADELINA FAMILY CHILD CARE
FACILITY NUMBER: 376630235
VISIT DATE: 01/03/2025
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LPA advised the applicant no changes should be made to the home without prior notice and/or approval from Licensing. The applicant states they are financially secure to operate a family childcare home for children and will comply with all regulations and laws governing family childcare homes.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. The applicant was also informed the following items are prohibited during daycare operating hours (walkers, exersaucers, jumpers, and bouncy seats). Corporal punishment and smoking are not allowed in the daycare.

On this date, 01/03/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ. LPA provided the applicant with the California Megan's Law website: www.meganslaw.ca.gov.

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC809 (FAS) - (06/04)
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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: FUENTES, ADELINA FAMILY CHILD CARE
FACILITY NUMBER: 376630235
VISIT DATE: 01/03/2025
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LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. The applicant understands they must physically check on sleeping infants every 15 minutes and document. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] will be maintained for each infant up to 12 months of age and shall be available to the Department for review. The applicant understands infants up to 12 months of age must be placed on their backs for sleeping.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication. LPA discussed and provided Licensee with the following: childcare advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

The maximum capacity for a large family childcare home (when there is an assistant present) 12- No more than 4 infants. CAP 14 no more than 3 infants.1 child in kindergarten or elementary school and 1 child at least age 6 including children under age 10 who live in the licensee's home. To access our Regulations and Forms please use our WEBSITE: http://ccld.ca.gov.

A large family daycare license or 14 may be issued may be issued upon a final file review. An exit interview was conducted, and the report was reviewed with the applicant, Adelina Fuentes.
SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2025
LIC809 (FAS) - (06/04)
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