376630733-5-21-2026-20-CC-DSTS-DUAW4L-20260521165745

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376630733
Report Date: 05/21/2026
Date Signed: 05/21/2026 04:57:57 PM

Document Has Been Signed on 05/21/2026 04:57 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	DOR, DALINEDA FAMILY CHILD CARE		FACILITY NUMBER:	376630733
ADMINISTRATOR/ DIRECTOR:	DALINEDA DOR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 909-2643
CITY:	LA MESA	STATE: CA	ZIP CODE:	91941
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	05/21/2026
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	03:30 PM
MET WITH:	Dalineda Dor		TIME VISIT/ INSPECTION COMPLETED:	05:00 PM

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 May 21, 2026 at 03:30 PM, Licensing Program Analyst (LPA) Dana Stevens conducted an announced Pre-licensing inspection with applicant, Dalineda Dor. Multilingual Technologies translator #98472560 provided assistance with translation as applicant's primary language is Haitian Creole. LPA disclosed the purpose of the inspection and was granted a tour into the facility by the Applicant. Purpose of the inspection is to ensure that the home is in compliance with standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. This three (3) bedroom, two (2) bathroom home was toured and inspected. The hours of operation are: Monday through Sunday, 6:00 a.m. to 10:00 p.m. Applicant will use the following areas for child care: Bedroom 1 (daycare room), hall bathroom, and back patio, which has a canopy and is set up as an outdoor classroom. Off limit areas include: bedroom #2, bedroom#3, bathroom #2, kitchen, living room and side yard. They are made inaccessible to day care children through the use of doorknob covers, door locks, and a safety gate. The back patio will be used for outdoor activities and is fully fenced. Applicant was reminded that continuous supervision is to be given to children whenever engaged in outdoor activities. Applicant stated there are no bodies of water and LPA did not observe any bodies of water during the time of this inspection. The fire extinguisher meets requirements and is located in the kitchen. Smoke and carbon monoxide detectors meet requirements and are operational. Applicant was advised all poisons shall be locked. Applicant states detergents and cleaning compounds are inaccessible to children in care and are located in an off-limits area and secured with a cupboard lock. Children’s toys, material, and play equipment are available. The applicant has a working telephone/cell phone. Applicant states there are no firearms at the time of this inspection. Fire Clearance for 14 children was received on 05/13/2026. Applicant is exempt from Mandated Reporter AB1207 training due to her primary language is Haitian Creole. Applicant has completed the 8 hours of preventative health. Pediatric CPR and First Aid certifications expire on September 2026. Applicant was advised all helpers will need to complete this training if left alone with children. Required documents are posted. Applicant and adult residents in the home have criminal record clearances on file.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Dana Stevens
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: DOR, DALINEDA FAMILY CHILD CARE	FACILITY NUMBER: 376630733
	VISIT DATE: 05/21/2026

NARRATIVE

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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.

LPA advised that prior to making alterations or additions to the home or grounds, the applicant shall notify the Department of the proposed change. Applicant states they are financially secure to operate a family child care home for children and will comply with all regulations and laws governing family child care homes.

Incidental Medical Services (IMS) policy was discussed with applicant. Applicant was advised that if she has children requiring IMS, to inform Licensing Program Analyst. 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.

On this date, 04/06/2026 the California Attorney General - Megan’s Law website (meganslaw.ca.gov) 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 addresses. 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.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Dana Stevens
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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: DOR, DALINEDA FAMILY CHILD CARE	FACILITY NUMBER: 376630733
	VISIT DATE: 05/21/2026

NARRATIVE

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The applicant provided proof of control of property. 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.

LPA discussed the maximum capacity for a large family child care home:
Maximum capacity (when there is an assistant present) is 12, no more than 4 infants; or , with Landlord Consent, a maximum capacity of 14, with no more than 3 infants, and 1 child in kindergarten or elementary school and 1 child at least age 6. The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC 9149), so maximum capacity at this time is 12.

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-andresources/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.

Please visit the Guardian web page and set-up your Guardian account. https://cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/caregiver-background-check/guardian. If you have any questions regarding Guardian, please contact CDSS at email: guardian@dss.ca.gov.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Dana Stevens
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

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: DOR, DALINEDA FAMILY CHILD CARE	FACILITY NUMBER: 376630733
	VISIT DATE: 05/21/2026

NARRATIVE

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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-carelicensing/subscribe and select the Child Care option to receive email communication.
Applicant was advised of the importance of reporting Unusual Incident Reports and the Duty Line was provided: (619) 767-2248.

Southern California Child Care Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.
Applicant was encouraged to subscribe through the CCLD website in order to be placed on an email list for updated regulation information.

No corrections are needed prior to the issuance of a regular license:

Exit interview conducted. A Large Family Child Care Home license may be issued upon final file review. A copy of this report was provided to the applicant.

NAME OF LICENSING PROGRAM MANAGER: Rajani Goudreau
NAME OF LICENSING PROGRAM ANALYST: Dana Stevens
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/21/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2026

LIC809 (FAS) - (06/04)

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