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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629375
Report Date: 12/29/2023
Date Signed: 12/29/2023 01:50:35 PM

Document Has Been Signed on 12/29/2023 01:50 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:HERNANDEZ, GLORIA ZAMAYOA FAMILY CHILD CAREFACILITY NUMBER:
376629375
ADMINISTRATOR:GLORIA ZAMAYOAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 743-9132
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
12/29/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Licensee, Gloria Zamayoa HernandezTIME COMPLETED:
02:00 PM
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On 12/29/2023 at 12:30 pm, Licensing Program Analyst (LPA) Daniela Huerta conducted an unannounced Case Management inspection to follow up on an incident that occurred at the facility on 04/01/2023 and to provide an amended report. LPA met with Licensee, Gloria Zamayoa Hernandez. LPA disclosed the purpose of the inspection and was granted a tour of the facility by the Licensee. There were four (4) daycare children and one (1) assistant present at the time of the inspection.

Based on Law Enforcement and Superior Court record review and interviews conducted, it was determined that on 04/01/2023, the licensee’s spouse engaged in conduct that required law enforcement intervention. During the incident, the licensee’s spouse used threatening language and threw objects in the residence, damaging items used by the family child care. The incident did not occur during hours of operation and no children were present. On 04/06/2023, the licensee’s spouse was charged with a violation of a “No Contact Protective Order” and ultimately convicted of trespass in October 2023.

During the course of the investigation, LPA Huerta was given false information by the Licensee regarding the spouse’s current residence and the last time he was present at the facility. Multiple witnesses have observed the licensee’s spouse at the facility as recent as 12/12/2023.

A Type A deficiency was cited under Health & Safety code 1596.885(c). See the LIC809D page.

Upon receipt of report licensee, Gloria Zamayoa Hernandez was notified that this report dated 12/29/2023 document one (1) Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Daniela Huerta
LICENSING EVALUATOR SIGNATURE: DATE: 12/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME: HERNANDEZ, GLORIA ZAMAYOA FAMILY CHILD CARE
FACILITY NUMBER: 376629375
VISIT DATE: 12/29/2023
NARRATIVE
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Also, upon receipt of report licensee was notified to provide a copy of this licensing report dated 12/29/2023 that documents any Type A citation 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.

An exit interview was conducted with Licensee, Gloria Zamayoa Hernandez. Licensee was provided a copy of the appeal rights (LIC 9058), the notice of site visit (LIC 9213) and observed it being posted at the facility. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Jason Garay
LICENSING EVALUATOR NAME: Daniela Huerta
LICENSING EVALUATOR SIGNATURE:

DATE: 12/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/29/2023 01:50 PM - It Cannot Be Edited


Created By: Daniela Huerta On 12/29/2023 at 01:01 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: HERNANDEZ, GLORIA ZAMAYOA FAMILY CHILD CARE
FACILITY NUMBER: 376629375

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/29/2023
Section Cited
HSC
1596.885(c)

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HSC Section 1596.885(c): Conduct Inimical. The department may…suspend or revoke any license…upon any of the following grounds...(c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility...

This requirement was not met as evidenced by:
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Analyst and licensee discussed the licensee's obligation to provide factual and accurate information and be truthful in all interactions with the Department. Licensee will submit a written statement to the San Diego Regional Office informing the Department on how she will abide by licensing regulations in regards to conduct inimical.
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Based on interviews conducted and records reviewed, it was determined that the licensee and licensee’s spouse have engaged in inimical conduct which poses an immediate Health and Safety Risk to children in care.
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LPA informed licensee that this information will be forwarded to the Department’s Legal Division for further review.

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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:Daniela Huerta
LICENSING EVALUATOR SIGNATURE:
DATE: 12/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/29/2023


LIC809 (FAS) - (06/04)
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