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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376101191
Report Date: 10/07/2024
Date Signed: 10/07/2024 02:54:13 PM

Document Has Been Signed on 10/07/2024 02:54 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:VALENZUELA ORTEGA, LISETT FCCFACILITY NUMBER:
376101191
ADMINISTRATOR/
DIRECTOR:		LISETT VALENZUELA ORTEGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 626-5653
CITY:EL CAJONSTATE: CAZIP CODE:
92021
CAPACITY: 12TOTAL ENROLLED CHILDREN: 10CENSUS: 4DATE:
10/07/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Lisett Valenzuela OrtegaTIME VISIT/
INSPECTION COMPLETED:
03:10 PM
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On 10/7/24 at 12:30pm, LPA Patrick Ma made an unannounced visit to follow up on self reported child injury report, received on 8/30/24. Upon entry, LPA met with Licensee Lisett Valenzuela Ortega and explained purpose of the visit. Present in the home were 4 day care children. LPA conducted children and Licensee interviews, made a confidential names list, and received a copy of the children’s roster.

Licensee observed child C1 running on the playground, tripped, and incurred an injury. 9-1-1 and parents were contacted soon after the injury. Child was taken to the hospital to seek medical attention. Child returned to the facility the next day without medical directives. LPA inspected playground. Playground is fully fenced into 2 separate playgrounds but is visible from both sides. Age-appropriate toys were available. Licensee stated there were 6 children at the time of incident (within ratio). No hazards were observed.

No deficiency cited.

Exit interview conducted and report was reviewed with the licensee Lisett Valenzuela Ortega. A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Renesha Askew
LICENSING EVALUATOR NAME: Patrick Ma
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2024
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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