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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376100600
Report Date: 05/28/2025
Date Signed: 05/28/2025 02:36:51 PM

Document Has Been Signed on 05/28/2025 02:36 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 N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME:AYALA, PATRICIA FCCFACILITY NUMBER:
376100600
ADMINISTRATOR/
DIRECTOR:		ANDREA V. & PATRICIA A.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(858) 412-5171
CITY:SAN DIEGOSTATE: CAZIP CODE:
92109
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
05/28/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Marisol BustamanteTIME VISIT/
INSPECTION COMPLETED:
02:55 PM
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On 5/28/25 at 12:30 PM Licensing Program Analyst (LPA) Annette Sutherland conducted an unannounced annual inspection with the Facility Helper Marisol Bustamante. Also present was additional helper Monica Nuno. Licensee is out for a few days for holiday weekend. Also, in the home was a maintenance worker who was in the off-limits area. The 2 story home was toured and inspected to ensure an environment safe for the care and supervision of children. Present in the home were 13 day care children. Licensee has provided adequate space for the children to eat, sleep and play within the home. Areas used for childcare include the lower ground level day care room, upstairs bathroom, balcony, and backyard. Off limits areas include the rest of the house and are inaccessible through use of safety gates and door knob covers. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities. Licensee understands that supervision is always required during outdoor activities. The fire extinguisher, smoke detector, and carbon monoxide detector meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. There are no bodies of water on the property. There are no weapons in the home. Licensee and helpers all have current First Aid, CPR, Mandated Reporter Training, and required immunizations. Children’s and Staff records were reviewed and found to be in order. LPA obtained an updated facility roster and observed required documents are posted in an area accessible to parent/guardians. Provider is hereby reminded of the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms; corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers are not allowed in day care. All equipment that is used should be used only as intended by the manufacturer. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.
NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Annette Sutherland
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/28/2025
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
SAN DIEGO N. CC RO, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108
FACILITY NAME: AYALA, PATRICIA FCC
FACILITY NUMBER: 376100600
VISIT DATE: 05/28/2025
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LPA reviewed with Licensee the LIC 311D, Forms/Records. To Keep in Your Family Childcare Homes, children’s forms/records, facility forms/records, and information to be posted.
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. Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Childcare Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated. LPA discussed the safe sleep regulations with licensee and discussed the Childcare Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA verified licensee is conducting and documenting the required 15-minute checks and has the completed and signed Sleeping Plan (LIC 9227) in the children’s files. Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. LPA discussed and provided Licensee with the following: childcare advocates-email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Childcare Licensing Duty Line at (619) 767-2248. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Childcare Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Childcare Centers and the ADA, available at: http://www.ada.gov/childqanda.htm No deficiencies cited. Exit interview conducted and report was reviewed with the licensee. During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.A notice of site visit was given and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Joelle Redding
NAME OF LICENSING PROGRAM ANALYST: Annette Sutherland
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC809 (FAS) - (06/04)
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