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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628204
Report Date: 09/19/2023
Date Signed: 09/19/2023 11:13:51 AM


Document Has Been Signed on 09/19/2023 11:13 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, MAYRA & WILFREDO FAMILY CHILD CAREFACILITY NUMBER:
376628204
ADMINISTRATOR:MAYRA & WILFREDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 305-5400
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY:14CENSUS: 4DATE:
09/19/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Mayra Rodriguez, ProviderTIME COMPLETED:
11:15 AM
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Licensing Program Analyst (LPA) Diana Sanchez, made an unannounced Case Management inspection to the facility to conduct a site inspection. LPA met with providers Mayra Rodriguez and Wilfredro Rodriguez, to tour the facility. LPA advised providers the purpose of today’s visit, to inspect the facility to ensure that the facility is in compliance with the rules and regulations of California Code of Regulations, Title 22, Division 12, Chapter 3, Regulations governing Family Child Care Homes. During today's inspection, there were four children and the two providers present. Appropriate ratios and capacity were observed. Appropriate care & visual supervision was also observed during the inspection.
The facility single story three bedroom and two bathroom house. LPA toured the facility and noticed that all of the required notices, License and forms were posted. The house smoke and carbon monoxide detectors are operable. Facility's fire extinguisher is fully charged.
The day care bathroom was inspected, it is clean and operable with good ventilation. Some of the kitchen bottom cabinets have been properly secured with child proof safety latches. The facility backyard is fully fenced and there are plenty of toys and equipment for outside activities. The playground structure has been firmly secured to the ground.
LPA reviewed staff and children records. All staff members have current CPR and First Aid certifications. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.
LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

There are no deficiencies cited on this inspection, all paperwork is in order and required documents were properly posted.
An exit interview was conducted with Mayra Rodriguez and a copy of this report left at the facility. Copy of this report shall be maintained in the facility for public review.
LPA observed provider placing the Notice to Cite Visit on the wall visible to parents during today’s inspection.
NOTICE OF SITE VISIT MUST BE POSTED FOR 30 DAYS
SUPERVISOR'S NAME: Jason GarayTELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Diana SanchezTELEPHONE: (619) 767- 2210
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2023
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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