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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334815556
Report Date: 09/26/2019
Date Signed: 09/26/2019 12:50:01 PM

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 ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:AGUILAR FAMILY CHILD CAREFACILITY NUMBER:
334815556
ADMINISTRATOR:AGUILAR, SILVERIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
7603961019
CITY:MECCASTATE: CAZIP CODE:
92254
CAPACITY:14CENSUS: 9DATE:
09/26/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Silveria Aguilar, LicenseeTIME COMPLETED:
01:00 PM
NARRATIVE
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On September 26, 2019 at 9am a case management inspection is being conducted by Licensing Program Analysts (LPAs) Giselle Carbullido and Carlos Martinez in response to an Unusual Incident Report received on 09/10/2019 from the facility. The UIR indicates that an uncleared and non-associated adult was working in the home. During today’s visit, LPAs met with Silveria Aguilar, Licensee and census was taken, with 9 children and 2 adults present.

LPAs interviewed Licensee, reviewed records and toured the facility.

Licensee stated that her assistant's son did help for 40 minutes one day. Licensee provided proof of finger prints and immunization' for the assistants son.

Based on the information gathered, the following violations have been identified: LPA verified staff has fingerprints but was not associated to the facility. See LIC809D for cited deficiencies of the California Code of Regulations, Title 22, Div. 12.

A Civil Penalty has been assessed during this inspection. Payment is due when billed and the check(s) or money orders shall be made payable to the “California Department of Social Services”. YOU WILL RECEIVE AN INVOICE IN THE MAIL. DO NOT SEND MONEY UNTIL YOU RECEIVE YOUR INVOICE. DO NOT SEND CASH.


An exit interview was conducted, appeal rights discussed, and a copy of this report was provided to facility staff.
SUPERVISOR'S NAME: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle CarbullidoTELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
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
Citations on this Visit Report are Under Appeal!

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501

FACILITY NAME: AGUILAR FAMILY CHILD CARE
FACILITY NUMBER: 334815556
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type A
09/27/2019
Section Cited

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102416(d)(3) Request and be approved for a transfer of a criminal record exemption, as specified in Section 102370.1(p), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility.This requirement was not met as evidenced by:
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Based upon LPA interview with Licensee, an unassociated adult was working in the home for one day.This is a potential health and safety risk to children in care.
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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: Gilbert SenaTELEPHONE: (951) 782-4844
LICENSING EVALUATOR NAME: Giselle CarbullidoTELEPHONE: (951) 970-1904
LICENSING EVALUATOR SIGNATURE:
DATE: 10/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/22/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2