376616900-10-2-2025-20-CC-GGOZ-DM3Q3F-20251002114840

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376616900
Report Date: 10/02/2025
Date Signed: 10/02/2025 11:48:56 AM

Document Has Been Signed on 10/02/2025 11:48 AM - 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:	VARGAS-JIMENEZ, ELIZABETH FAMILY CHILD CARE		FACILITY NUMBER:	376616900
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	10/02/2025
TYPE OF VISIT:	Office	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:40 AM
MET WITH:	Elizabeth Vargas-Jimenez		TIME VISIT/ INSPECTION COMPLETED:	11:50 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On October 2, 2025, at 10:40 AM, an office meeting was conducted with Licensee, Elizabeth Vargas-Jimenez, at the Child Care Regional Office to discuss multiple citations issued on July 23, 2025. Present at the meeting was Licensing Program Manager (LPM) Tulam Vu and Licensing Program Analyst (LPA) Gloria Gonzalez. During an annual inspection conducted on July 23, 2025 the following citations were issued: Type A deficiency-102425(h): Infant Safe Sleep- Child #1, that was about nine months old, was observed sleeping in a car seat. Licensee stated she will remove infants from car seats as soon as they arrive to the facility. Typ B deficiencies: 102425 (j)(2)(D)(c ) and (c )(2) Licensee did not conduct safe sleep checks every 15 minutes, did not document safe sleep checks and document it, and did not have the LIC9227 in child's file. 102417(g)(5), (g) (3), (g)(4), and (g)(9)(A)1- Jacuzzi was not latched and locked making it accessible to children, the stairs were not barricaded, cleaning compounds accessible to children, did not conduct and document disaster drills. Licensee stated she will check the Jacuzzi is covered and locked, and the cover can support the weight of an adult once a week. HSC 1596.8662(b)(1)- Licensee did not have a current mandated reporter certificate for Licensee and Staff. 102421(c ) Children's records- Licensee did not have the LIC9150 Parent Notification in child's file.

NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Gloria Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: VARGAS-JIMENEZ, ELIZABETH FAMILY CHILD CARE	FACILITY NUMBER: 376616900
	VISIT DATE: 10/02/2025

NARRATIVE

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102416(c ) Personnel Requirements -Licensee did not have a current 1st Aid & CPR certificate.

HSC 1597.622(a)(1)- Licensee did not have proof of immunization's for Staff.

Licensee stated she will set up reminders to remind her of all required training's due and disaster drills. Licensee stated she will ensure the stairs are barricaded as long as there are children under five years old.

A Plan of Correction (POC) visit was conducted on August 26, 2025 and all citations were cleared on this date.

LPM discussed with Licensee the above deficiencies. Licensee was provided with the following resources: A Technical Support Program (TSP) brochure, email: childcaretechnicalsupport@dss.ca.gov. Licensee has accepted to receive a TSP referral. Licensee stated she utilizes R&R and Chicano Federation resource training's. Licensee was provided information on CCL videos at www.ccld.ca.gov.

Licensee was provided the above regulations and the following link to take the Child Care Home Orientation www.ccld.ca.gov. The in person orientation will conducted on October 8, 2025. Duty Line at (619) 767-2248.
On 6/12/25 Licensee submitted an application for a large license from 8 children to 14 children. A granted fire clearance was received on 7/7/25. A Large Family Child Care Home license will be issued as of today 10/2/25.

Licensee was informed that repeated violations or failure to comply with licensing laws and regulations may result in administrative action taken by the Department. Licensee, Elizabeth Vargas-Jimenez stated she understood and will ensure the facility complies with all regulations and laws governing Child Care Homes.

A copy of this report was given to Licensee. Appeal Rights (LIC 9058) was provided. An exit interview was conducted and the report was reviewed with Licensee, Elizabeth Vargas-Jimenez.

NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Gloria Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/02/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2025

LIC809 (FAS) - (06/04)

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