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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364813437
Report Date: 09/14/2023
Date Signed: 09/14/2023 03:27:30 PM

Document Has Been Signed on 09/14/2023 03:27 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, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:ROCES-LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
364813437
ADMINISTRATOR:ROCES-LOPEZ, JOCELYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 283-4195
CITY:LOMA LINDASTATE: CAZIP CODE:
92354
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
09/14/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:28 PM
MET WITH:Jocelyn Roces-LopezTIME COMPLETED:
03:35 PM
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On this date and time, Licensing Program Analysts (LPA's) Laura Mejorado and Susan Brewer arrived at the facility to conduct an inspection regarding a separate matter. LPA's met with Licensee Jocelyn Roces-Lopez, also present were 5 daycare children. LPA's toured the facility, verified associations, and took census. The following was discussed:

On 7/11/23 LPAs conducted an inspection at the facility regarding a separate matter and observed staff member, S1, present at the facility and assisting with the daycare children. At that time Licensee identified S1 by the false name of another staff member associated to the facility. Licensee later admitted to giving S1 a false name and provided S1's real name. S1 began working at the facility on 4/26/23, off and on, two days a week in the afternoons as needed. S1 did not obtain a criminal record clearance prior to working at the facility. As of today, S1 has not obtained a criminal record clearance or began the fingerprinting process. Per Licensee, S1 is no longer employed at the facility and their last day of employment was 7/11/23. This is in violation of 102370(d)(1) Criminal Record Clearance.

Additionally, LPAs were informed another staff member, S2, has been assisting with the daycare. Based on Licensees own admission S2 was assisting with the daycare without a fingerprint clearance from 4/25/23 until 7/14/23, off and on, two days a week in the afternoons as needed. S2 was granted a criminal record clearance on 7/14/23 and is currently still employed by the facility. This is in violation of 102370(d)(1) Criminal Record Clearance.

See LIC809D for cited deficiencies of the California Code of Regulations, Title 22.

Civil penalties were assessed during today’s inspection.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE: DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/14/2023
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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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: ROCES-LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 364813437
VISIT DATE: 09/14/2023
NARRATIVE
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If 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.

LPA's Mejorado and Brewer informed licensee Jocelyn Roces-Lopez that this report dated 9/14/23 documents 1 Type A citations which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

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.



Also, LPA's Mejorado and Brewer informed the licensee Jocelyn Roces-Lopez to provide a copy of this licensing report dated 7/11/23 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Kimberly Williams
LICENSING EVALUATOR NAME: Laura Mejorado
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 09/14/2023 03:27 PM - It Cannot Be Edited


Created By: Laura Mejorado On 09/14/2023 at 12:35 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: ROCES-LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 364813437

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/15/2023
Section Cited
CCR
102370(d)(1)

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(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:(1) Obtain a California clearance or a criminal record exemption...
This requirement is not met as evidence by:
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Immediately, Licensee agrees to adhere to the regulations pertaining to criminal record clearance. Licensee stated S1 no longer works at the daycare and S2 obtained a criminal record clearance on 7/14/23.
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Based on observation, interview and Licensees admission, S1 and S2 assisted with the daycare without obtaining a criminal record clearance, which poses an immediate Health, Safety, or Personal Rights risk to persons in care.
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Licensee agrees to submit a written statement with their understatement of this regulation and their detailed plan on how compliance with be maintained. Licensee agrees to submit proof to CCL by 9/15/23.

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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:Kimberly Williams
LICENSING EVALUATOR NAME:Laura Mejorado
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2023


LIC809 (FAS) - (06/04)
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