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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376608782
Report Date: 12/22/2023
Date Signed: 12/22/2023 03:30:57 PM


Document Has Been Signed on 12/22/2023 03:30 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
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108



FACILITY NAME:RIVAS, ROSA & FAUSTO FAMILY CHILD CAREFACILITY NUMBER:
376608782
ADMINISTRATOR:ROSA RIVASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 475-4686
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY:14CENSUS: 0DATE:
12/22/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Rosa RivasTIME COMPLETED:
03:15 PM
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On this date and time, Licensing Program Analyst (LPA) Adrian Castellon arrived at facility to conduct a Case Management visit to follow-up on a Notice to Cease Operation letter which was reviewed over the phone on December 19, 2023 (Spanish translation provided). Present during the phone call was Licensee, Rosa Rivas; Licensing Program Manager (LPM), Cynthia Gray; Regional Managers (RMs) Kimberly Williams and Kim Hall and LPA, Adrian Castellon.

During today’s inspection LPA Castellon met with Licensee, Rosa Rivas. Co-Licensee, Fausto Rivas was not present in the home. Per Mrs. Rivas, Fausto Rivas cannot currently reside in the home based on San Diego court orders. This inspection was conducted in Spanish per licensee's request. LPA took census, toured the facility, inside and out, and reviewed children and staff records.

LPA provided Licensee with a copy of the Notice to Cease Operation letter issued by the department in accordance with Title 22 Regulation section 102370(n)(1) which states in part “…If the Department determines that any licensee or individual specified in Health and Safety Code Section 1596.871(b) is arrested for a crime for which, if convicted, an individual is not eligible, by law, to receive an exemption, pending completion of its investigation into the facts underlying the arrest, the Department may take the following actions as it deems necessary: (1) If the arrested individual is a licensee, the Department may notify the licensee, by telephone or in writing, to immediately cease operation for up to 30 days.” The Notice to Cease Operation letter was emailed and mailed (regular and certified) to Licensee on December 19, 2023. Licensee acknowledged understanding of the notice and did not have any additional questions at this time. Licensee was advised if they had any questions regarding the Notice to Cease Operation, they may contact the office at (619) 767-2200 and ask to speak with LPA Castellon and/or management.

Exit interview was conducted and report was reviewed with Licensee, Rosa Rivas. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Cynthia GrayTELEPHONE: (619) 767-2258
LICENSING EVALUATOR NAME: Adrian CastellonTELEPHONE: (619) 767-2237
LICENSING EVALUATOR SIGNATURE:
DATE: 12/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/22/2023
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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