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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376624281
Report Date: 02/24/2025
Date Signed: 02/24/2025 01:37:07 PM

Document Has Been Signed on 02/24/2025 01:37 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:VELASCO, IRMA FAMILY CHILD CAREFACILITY NUMBER:
376624281
ADMINISTRATOR/
DIRECTOR:		IRMA VELASCOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 551-8466
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
02/24/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:00 AM
MET WITH:Licensee - Irma VelascoTIME VISIT/
INSPECTION COMPLETED:
01:50 PM
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On 02/24/2025 at 10:00 AM, Licensing Program Analyst (LPA) Julieta Abrego, made an unannounced visit to follow up on a self-reported incident that occurred on 11/07/2024, wherein an 8 month old hit his face on the edge of a changing table located in the daycare room. The child sustained a small cut above the right eyebrow. LPA met with the licensee.

LPA interviewed the licensee. LPA inspected the area where the injury occurred. LPA obtained a picture taken by the licensee of the injury. LPA obtained a copy of the children's roster and communication between the licensee and the parent.

Further investigation is needed on the incident that occurred on 11/07/2024. An exit interview was conducted, and the report was reviewed with the licensee Irma Velasco. The director was provided a copy of the appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. No deficiencies were cited.
SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Julieta Abrego
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2025
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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