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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376628204
Report Date: 12/02/2024
Date Signed: 12/02/2024 02:06:55 PM

Document Has Been Signed on 12/02/2024 02:06 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:RODRIGUEZ, MAYRA & WILFREDO FAMILY CHILD CAREFACILITY NUMBER:
376628204
ADMINISTRATOR/
DIRECTOR:		MAYRA & WILFREDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 305-5400
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
12/02/2024
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:55 PM
MET WITH:Licensee - Mayra RodriguezTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 12/02/2024 at 12:55 PM Licensing Program Analyst's (LPA's) Julieta Abrego and Michelle Hood made an unannounced Case Management inspection to the facility to conduct a site inspection. LPA's met with licensees Mayra and Wilfredo Rodriguez. LPA advised licensees 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 5 children and the 2 licensees present.

LPA's toured the facility and observed all of the required postings and forms were posted. LPA's obtained a copy of the facility roster. The fire extinguisher is rated 3-A:40-B-C and meets requirements. The smoke and carbon monoxide detectors are operable. The fireplace is barricaded. The off limits areas are made inaccessible by door knob covers and safety gates. 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. LPA reviewed children records. Licensees have current CPR and First Aid certifications and Mandated Reporter training.

An exit interview was conducted, and the report was reviewed with the licensee Mayra Rodriguez. The licensing report will be e-mailed to the licensee and the licensee was advised that acknowledgment of receipt of the report and appeal rights are to be received within twenty-four hours. LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited.
SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE: DATE: 12/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/02/2024
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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