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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376616501
Report Date: 01/24/2025
Date Signed: 01/24/2025 03:08:29 PM

Document Has Been Signed on 01/24/2025 03:08 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:MATA, HORTENCIA FAMILY CHILD CAREFACILITY NUMBER:
376616501
ADMINISTRATOR/
DIRECTOR:		HORTENCIA MATAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 525-8059
CITY:ESCONDIDOSTATE: CAZIP CODE:
92027
CAPACITY: 14TOTAL ENROLLED CHILDREN: 18CENSUS: 10DATE:
01/24/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:23 PM
MET WITH:Licensee Hortencia Mata TIME VISIT/
INSPECTION COMPLETED:
03:29 PM
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 On date and time listed, Licensing Program Analyst (LPA) Kelly Gerth arrived at the facility to conduct an annual inspection as part of a compliance review. LPA toured the facility, inside and out, records were reviewed, and the following was observed and/or discussed:
· Normal days and hours of operation are: Monday- Friday, 23 hrs. and 59 minutes
· Off-limit areas include: 3 Bedrooms, Front hallway bathroom, 2 side yards, kitchen, living/dining room, office.
· The facility is licensed to have no more than 14 children as a large FCCH and is operating within the licensed capacity and appropriate ratios. 10 were present with 3 staff during the inspection.
· Appropriate supervision was being provided during this inspection
· A working telephone is present, and the current phone number is on file
· A fully charged fire extinguisher (2A:10BC) was observed. A smoke detector and carbon monoxide detector were present.
· 2 Fireplaces in off limits office and Living room, are properly screened to prevent access by children.
· All hazardous items are stored inaccessible to children, kept in off limits locked kitchen pantry
· Toxins are locked and inaccessible to children in care, Where
· Weapons are not present. Licensee Hortencia Mata understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 Regulations
· Home is one level, without stairs
· Clean, safe, and age-appropriate toys are provided
· Current roster on file
· Facility Sketch, Emergency Disaster Plan and Notification of Parent’s Rights posted.
· Documentation of fire and disaster drills are on file – Last drill 01/06/2025
· No bodies of water are present at this time. Licensee understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position. See Next Page
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE: DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/24/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MATA, HORTENCIA FAMILY CHILD CARE
FACILITY NUMBER: 376616501
VISIT DATE: 01/24/2025
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· Verification of control of property is on file
· Children’s records are complete
· Employee’s records are complete
· Mandated Reporter Training expires on: 04/24/25
· Pediatric CPR and First Aid Card expires on: 04/25/25
· Health & Safety Certificate - completed on: 09/13/04
· Resident and/or staff records were reviewed and all adults who require caregiver background checks have received all required clearances and/or exemptions.
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send them email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
Licensee Hortencia Mata was reminded that all adults 18 and over, living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with Licensee Hortencia Mata and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleepmaximum of as an additional resource. LPA also informed Licensee Hortencia Mata 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.
See Next Page
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: MATA, HORTENCIA FAMILY CHILD CARE
FACILITY NUMBER: 376616501
VISIT DATE: 01/24/2025
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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee Hortencia Mata was informed of the www.MyChildCarePlan.org; a consumer education website which helps families obtain childcare via connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. The link to “Receive Important Updates” -located above Quick Links, right side of the page, one can add an email address, choose which program(s) they wish to receive Provider Information Notices (PIN) for.


Licensee Hortencia Mata was reminded to ensure the LIC 610A Emergency Disaster Plan for Family ChildCare Homes was up to date with 2 temporary relocation sites, one within close proximity and one of 10 miles or more distance.
The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200
There are no deficiencies being cited at this time.

During the exit interview with Licensee Hortencia Mata, 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.

An exit interview was conducted, and this report was reviewed with Licensee Hortencia Mata and appeal rights were discussed and provided during the exit interview.
SUPERVISORS NAME: Carlos Martinez
LICENSING EVALUATOR NAME: Kelly Gerth
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC809 (FAS) - (06/04)
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