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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629022
Report Date: 10/12/2023
Date Signed: 10/12/2023 04:44:05 PM

Document Has Been Signed on 10/12/2023 04:44 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: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: 3DATE:
10/12/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:20 PM
MET WITH:Carmen Rocha, licenseeTIME COMPLETED:
04:30 PM
NARRATIVE
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On 10/12/2023, Licensing Program Analysts (LPAs) Edgar Campana and Thien Vu Dinh conducted an unannounced inspection of facility and met with licensee Carmen Rocha. During the course of the inspection, licensee and her spouse impeded with LPAs' attempt to interview children in care.

Per California Code of Regulations, (Title 22, division 12 & Chapter 3) one (1) Type A citation is being cited on the attached LIC 809-D.

LPA Edgar Campana informed Licensee, Carmen Rocha that this report dated 10/12/23 document(s) one (1) Type A citation(s) which shall be posted for 30 consecutive days as there is immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Edgar Campana informed the Licensee, Carmen Rocha to provide a copy of this licensing report dated 10/12/23 that documents Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A $500.00 Immediate Civil Penalty was assessed (see LIC421IM) for violation of inspection authority.

Exit interview conducted and report was reviewed with Licensee, Carmen Rocha. A copy of this report, along with Appeal Rights (LIC9058), were provided. A 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.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Edgar Campana
LICENSING EVALUATOR SIGNATURE: DATE: 10/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/12/2023
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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Document Has Been Signed on 10/12/2023 04:44 PM - It Cannot Be Edited


Created By: Edgar Campana On 10/12/2023 at 04:04 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: ROCHA, CARMEN FAMILY CHILD CARE
FACILITY NUMBER: 376629022

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/12/2023
Section Cited
CCR
102391(b)

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The licensee shall permit the Department to inspect the family child care home, and to privately interview children or staff, to determine compliance with or to prevent violations of family child care laws or regulations. The Department shall exercise this authority * as specified in Health and Safety Code Section 1596.8535(a).

This requirement was not met as evidenced by:
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Licensee stated that she spoke with parents and they refused for Department to interview children.
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Licensee impeded the LPA's attempts to interview daycare children in care, which poses an immediate threat to the health and safety of children in care.
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An office meeting at the San Diego Regional Child Care office will be scheduled in the near future.

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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:Edgar Campana
LICENSING EVALUATOR SIGNATURE:
DATE: 10/12/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/12/2023


LIC809 (FAS) - (06/04)
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