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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376620369
Report Date: 12/28/2022
Date Signed: 12/28/2022 01:47:40 PM

Document Has Been Signed on 12/28/2022 01:47 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:VILLEGAS, ROSA FAMILY CHILD CAREFACILITY NUMBER:
376620369
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
12/28/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Rosa VillegasTIME COMPLETED:
02:00 PM
NARRATIVE
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On 12/28/22 at 10:40AM, LPA Luigi Gargaro conducted an unannounced capacity increase visit with the licensee. Analyst met with the licensee, Rosa Villegas. Ms. Villegas understands some English but her husband, cleared and associated Filemon Villegas, assisted with translation today. The one story home was toured and inspected to ensure an environment safe for the care and supervision of children. The fire extinguisher and smoke and carbon monoxide detectors meet requirements and are operational. All hazardous items were latched/locked and secured out of reach of children. Analyst inquired of the applicant about whether there were any bodies of water or weapons in the home and she replied no. 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. The home appears to be large enough to comfortably accommodate 14 children. Fire clearance was received on 12/13/22. First Aid and CPR certifications expire in August of 2023 for both the licensee and her spouse.

Licensee will be using the following rooms for childcare: the kitchen, the living room, the first bedroom and the bathroom. The following areas will be off limits: the master bedroom and the small outdoor laundry area before the main yard that contains laundry equipment and other personal items. The master bedroom is made inaccessible through use of a door lock. The outdoor area before the yard is made off limits with a locking kitchen door and a picket fence that separates the play yard from laundry area. Children do not walk through the laundry area to get to the play yard. They are escorted through the front gate so they do not access the laundry area. The licensee has sufficient toys and equipment available. The home has a fenced backyard available for outdoor activities.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE: DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/28/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: VILLEGAS, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376620369
VISIT DATE: 12/28/2022
NARRATIVE
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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 Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

LPA and licensee discussed California Megan's Law and he provided licensee with the website address: www.meganslaw.ca.gov for her to review information regarding her facility on a regular basis. Unusual Incident Reports may be e-mailed to: SDIncidentReports@dss.ca.gov.

The following information was reviewed with the applicant: information on reporting requirements for suspected child abuse and unusual incidents, children’s records, immunizations, adults living or working in the home and related civil penalties, shaken baby syndrome, and SIDS. Licensee was reminded that corporal punishment, smoking, walkers, exersaucers, bouncy seats and jumpers are not allowed in day care.

Licensee was re-cited four type B violations that were not completed during the last home inspection visit. However, the home was in otherwise sufficient compliance and a license for 14 will be issued effective today. Analyst printed a copy of the Notice Of Site Visit today and had licensee place it in her facility notice area before he left the home.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:

DATE: 12/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2022
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 12/28/2022 01:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 12/28/2022 at 12:10 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: VILLEGAS, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376620369

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/09/2023
Section Cited
CCR
102425(j)(2)(B)

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102425 - Infant Safe Sleep - (j)(2)(B) The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.

This requirement is not met as evidenced by:
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Licensee was unable to fully complete safe sleep log at time of previous 11/08/22 citation. Licensee states she will begin observing and documenting all her infants napping starting today, 12/28/22, through 01/06/23 and submit a copy of those logs to analyst by 01/09/22 to complete the correction.
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Based on interview and record review, the licensee did not comply with the section cited above as she was unaware of the safe sleep regulations and was not maintaining records for napping infants which poses/posed a potential health, safety or personal rights risk to children in care.
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Type B
01/09/2023
Section Cited
CCR102417(g)(A)1

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102417 - Operation of a Family Child Care Home - (g)(A)1 Each family child care home shall conduct fire drills and disaster drills at least once every six months. The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home.

This requirement is not met as evidenced by:
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Licensee was unable to complete disaster drill log at time of previous 11/08/22 citation .Licensee states she will conduct both drills with the children in care and document them on a drill log and submit a copy to analyst by 01/09/23 to complete the correction.
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Based on interview and record review, the licensee did not comply with the section cited above as she stated she has not conducted fire and disaster drills in the past six months which poses/posed a potential health, safety or personal rights risk to children in care.
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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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2022


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Document Has Been Signed on 12/28/2022 01:47 PM - It Cannot Be Edited


Created By: Luigi Gargaro On 12/28/2022 at 01:09 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: VILLEGAS, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376620369

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/28/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/30/2023
Section Cited
HSC
1596.8662(b)(1)

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(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training ...and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
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Licensee and spouse were unable to complete Mandated Reporter Training class violation cited at time of previous 11/08/22 visit. Analyst provided licensee with the Mandated Reporter Training website information
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Based on interview and record review, the licensee did not comply with the section cited above as both she and spouse, who assists with the say care, have not completed the required mandated reporter training which poses/posed a potential health, safety or personal rights risk to children in care.
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Licensee and spouse state they will take the training and submit a copy of the certificate of completion to analyst by 01/30/23 to complete the correction.
Type B
01/30/2023
Section Cited
HSC1597.622(c)

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(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
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Licensee spouse was unable to obtain copy of his immunization records for the violation cited during previous 11/08/22 visit. Licensee states spouse will obtain a copy of his vaccination records or
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Based on record review, the licensee did not comply with the section cited above as her spouse did not have a copy of his immunizaton records on file at the facility which poses/posed a potential health, safety or personal rights risk to children in care.
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proof of immunity from his physician and provide those records to analyst by 01/30/23 to complete the correction.
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:Jason Garay
LICENSING EVALUATOR NAME:Luigi Gargaro
LICENSING EVALUATOR SIGNATURE:
DATE: 12/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/28/2022


LIC809 (FAS) - (06/04)
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