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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629022
Report Date: 10/24/2023
Date Signed: 10/24/2023 11:50:33 AM

Document Has Been Signed on 10/24/2023 11:50 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:ROCHA, CARMEN FAMILY CHILD CAREFACILITY NUMBER:
376629022
ADMINISTRATOR:CARMEN ROCHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 403-9350
CITY:SPRING VALLEYSTATE: CAZIP CODE:
91978
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/24/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Carmen RochaTIME COMPLETED:
11:50 AM
NARRATIVE
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On October 24th, 2023, at 10:30 AM, an office meeting was conducted with the licensee, Carmen Rocha to discuss recent citations issued on October 12th, 2023. Present at the meeting was Licensing Program Manager (LPM) Tulam Vu, LPM Jason Garay, Licensing Program Analyst (LPA) Edgar Campana, licensee's spouse, Jose Rocha, and United Domestic Workers (UDW) union representative, Trang Pham.

On October 12th, 2023, a Type A deficiency of the California Code of Regulation (CCR) Section 102391(b) Inspection Authority was cited due to licensee impeding LPA's ability to conduct interviews of children in care at family child care home.

A copy of Inspection Authority regulations were provided to the Licensee and discussed during this meeting. The complaint investigation process was also discussed, as well as the importance of the Department being allowed to interview children in care.

The licensee stated that she understood and would cooperate with the Department going forward.

Exit interview conducted and report was reviewed with Licensee, Carmen Rocha. Licensee was provided with Duty Line phone number: 619-767-2248
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE: DATE: 10/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/24/2023
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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