<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376617485
Report Date: 03/22/2023
Date Signed: 03/22/2023 04:32:42 PM

Document Has Been Signed on 03/22/2023 04:32 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:ACOSTA, ALMA FAMILY CHILD CAREFACILITY NUMBER:
376617485
ADMINISTRATOR:ALMA ACOSTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 280-1515
CITY:SAN DIEGOSTATE: CAZIP CODE:
92115
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
03/22/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:31 PM
MET WITH:TIME COMPLETED:
05:00 PM
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 3/22/23 at 3:31 PM, Licensing Program Analysts (LPAs) Annette Sutherland and Keturah Lane conducted a case management visit for deficiency cited. During today's visit, Licensee was not home and will not return until Friday 3/24/23. Facility helpers Claudia Reynoso and Stephany Villa Lopez were present with 8 children.

During the visit information was obtained from parent and child interviews that established that an associated individual was picking up children from school and transporting them to an unlicensed facility.

Type B deficiencies cited on LIC 809D see civil penalties assessed.

An exit interview was conducted with Ms. Reynoso. Notice of Site Visit (LIC 9213, Appeal Rights (LIC 9058) and a copy of the report (LIC809) was provided to Director .The Notice of Site Visit was posted during todays visits. Notice of site Visit must remain posted for 30 days.
SUPERVISORS NAME: Monica Cuddy
LICENSING EVALUATOR NAME: Annette Sutherland
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2023
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 2
Document Has Been Signed on 03/22/2023 04:32 PM - It Cannot Be Edited


Created By: Annette Sutherland On 03/22/2023 at 03:55 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
, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: ACOSTA, ALMA FAMILY CHILD CARE
FACILITY NUMBER: 376617485

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/05/2023
Section Cited
CCR
102395(a)(1)

1
2
3
4
5
6
7
 102395 (a)An immediate penalty of $100 per cited violation per day for a maximum of five (5) days shall be assessed for the following: (1) Failure to obtain a California clearance or criminal record exemption, request a transfer of a criminal record clearance or request and be approved for a transfer of an exemption as specified in Section 102370(d) for any individual required to be fingerprinted under Health and Safety Code Section 1596.871 prior to allowing the individual to work, reside or volunteer in the facility.This requirement was not met as evidenced by.....
1
2
3
4
5
6
7
Licnesee will provide a written statement on how she will make a correction upon her return and the children shall remain in licnesee's care during the hours they are cared for.
8
9
10
11
12
13
14
Based upon interviews with enrolled children, it was determined that licensee was allowing an unassociated individual to pick up the children from school, which is a potential health, safety and personal rights risk to children in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Monica Cuddy
LICENSING EVALUATOR NAME:Annette Sutherland
LICENSING EVALUATOR SIGNATURE:
DATE: 03/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/22/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2