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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376622185
Report Date: 08/17/2022
Date Signed: 12/13/2022 08:54:29 AM

Document Has Been Signed on 12/13/2022 08:54 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:PASTENES, ERICA FAMILY CHILD CAREFACILITY NUMBER:
376622185
ADMINISTRATOR:ERICA PASTENESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 964-6578
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
08/17/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Erica PastenesTIME COMPLETED:
04:30 PM
NARRATIVE
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On 8/17/22 at 3:45pm, LPA Adrian Castellon conducted a case management inspection. The purpose of the inspection is to issue a citation. LPA Castellon met with licensee Erica Pastenes and discussed the purpose of the inspection. There were four day-care children present.

During the course of a complaint inspection conducted on 8/12/22, a deficiency was observed separate from the complaint allegations. This LIC809, LIC809D, and LIC421M will be used to memorialize the following deficiency: 102417(a) Operation of a Family Child Care Home (Type A) – On 8/12/22, LPA Castellon observed a daycare child enter the facility with licensee Pastenes' minor son. There were no adults present. LPA Castellon conducted interviews with licensee Pastenes, daycare parent, and daycare child regarding incident. Licensee Pastenes and child interviewed state that child walked to the facility from school without the consent or knowledge of licensee Pastenes. Please see LIC809D for deficiencies. An immediate civil penalty of $500 was also issued on this date.

A copy of today's report was given to licensee Pastenes. Appeals Rights were given to and discussed with licensee Pastenes. Notice of Site inspection was given to licensee Miranda and posting requirement was discussed. LIC9224 Reporting Requirement was discussed on this date.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/17/2022
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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Document Has Been Signed on 12/13/2022 08:54 AM - It Cannot Be Edited


Created By: Adrian Castellon On 08/12/2022 at 02:26 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: PASTENES, ERICA FAMILY CHILD CARE
FACILITY NUMBER: 376622185

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
08/22/2022
Section Cited
CCR
102417(a)

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102417(a) Operation of a Family Child Care Home: The licensee shall be present in the home and shall ensure that children in care are supervised at all times... the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence...This requirement was not met as evidenced by LPA Castellon ob

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Licensee Pastenes will be present at the facility or have a fingerprint cleared adult present at the facility when there are daycare children present. Licensee will advise all daycare parents that children are not to leave their designated pick up areas untill licensee arrives. Licensee will advise parents that children are not permitted to be at the facility
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Castellon observed a day care child enter the facility with licensee's minor son. There were no adults present. This poses and immediate health and safety risk to children in care.

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without an adult present. Licensee will have parents sign and date such document and will submit to the licensing office.

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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:Cynthia Gray
LICENSING EVALUATOR NAME:Adrian Castellon
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022


LIC809 (FAS) - (06/04)
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