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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629497
Report Date: 10/23/2025
Date Signed: 10/23/2025 12:34:32 PM

Document Has Been Signed on 10/23/2025 12:34 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:JUAREZ, ROSA FAMILY CHILD CAREFACILITY NUMBER:
376629497
ADMINISTRATOR/
DIRECTOR:		ROSA JUAREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 847-5081
CITY:SAN DIEGOSTATE: CAZIP CODE:
92105
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 5DATE:
10/23/2025
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:40 AM
MET WITH:Rosa JuarezTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On 10/23/2025, at 10:40 a.m., Licensing Program Analyst (LPA), Victoria Felix conducted an unannounced Annual Inspection and met with Licensee, Rosa Juarez. LPA disclosed the purpose of the inspection and was led on a tour of the facility indoors and outdoors. This facility is a two-story home with five (5) bedrooms and three (3) bathrooms. The areas used for childcare include living room #1, living room #2 (referred to as the “childcare area”), bedroom #5 (where the infant crib is located), bathroom #3, half of the backyard, and the front yard. Off-limit areas include the entire second floor, which consists of bedroom #1 and bathroom #1. The off-limit areas on the first floor include bedrooms #2, #3, and #4, bathroom #2, the kitchen, and the other half of the backyard. These areas are made inaccessible to children through the use of safety gates, locks, and doorknob covers. The facility operates Monday through Friday, from 6:00 a.m. to 11:50 p.m. During the inspection, there were five (5) children and two (2) adults present.

The fire extinguisher met regulatory requirements; however, the smoke detector and carbon monoxide detector did not meet requirements. Please refer to LIC 809-D for additional information. Hazardous items were inaccessible to children in care. LPA did not observe any poisons during the inspection. The storage area for poisons is locked. LPA observed toys and materials available for children’s use. The home has a fenced backyard available for outdoor activities. LPA informed licensee to ensure children are supervised at all times during outdoor activities. There is no fireplace on the premises. Licensee stated there are no bodies of water and LPA did not observe any bodies of water during the inspection. Licensee stated there are no firearms, other weapons, or ammunition in the home.

A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions. LPA reviewed children’s files. Children’s files reviewed were complete and met regulations.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Victoria Felix
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/23/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: JUAREZ, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376629497
VISIT DATE: 10/23/2025
NARRATIVE
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated. During today’s inspection, Daniela Rivera Juarez was not cleared to be around children. The licensee received a Type B citation. Please refer to LIC 809-D for additional information.

Licensee’s Mandated Reporter AB1207 training expires 3/2026. Pediatric CPR and First Aid certifications expire on 03/2026. Licensee has required immunizations, per file review. Facility roster is maintained and was reviewed. The licensee conducted and documented a fire and disaster drill on 06/10/2025. Required documents are posted. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: https://www.cpsc.gov/, and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Victoria Felix
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC809 (FAS) - (06/04)
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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: JUAREZ, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376629497
VISIT DATE: 10/23/2025
NARRATIVE
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LPA reviewed with licensee the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA and licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov. LPA discussed and provided Licensee with the following: childcare advocates email address: childcareadvocatesprogram@dss.ca.gov. In addition, for general questions or questions licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.During the exit interview, the licensee, Rosa Juarez, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.


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

LPA Victoria Felix informed Licensee Rosa Juarez, on that this report dated 10/23/25 documents (1) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Victoria Felix informed the Licensee, Rosa Juarez to provide a copy of this licensing report dated 10/23/25 that documents 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.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee, Rosa Juarez.
NAME OF LICENSING PROGRAM MANAGER: Jason Garay
NAME OF LICENSING PROGRAM ANALYST: Victoria Felix
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/23/2025 12:34 PM - It Cannot Be Edited


Created By: Victoria Felix On 10/23/2025 at 12:01 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: JUAREZ, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376629497

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
1596.871(c)(1)(A)


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above. One (1) adult, Daniela Rivera Juarez, did not have the required clearance to supervise children, which poses an immediate health, safety, or personal rights risk to persons in care.
POC Due Date: 10/24/2025
Plan of Correction
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The licensee stated that Daniela Rivera Juarez will submit fingerprints to the SDRO for background clearance on 10/24/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Victoria Felix
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/23/2025 12:34 PM - It Cannot Be Edited


Created By: Victoria Felix On 10/23/2025 at 12:07 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: JUAREZ, ROSA FAMILY CHILD CARE
FACILITY NUMBER: 376629497

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
1597.543


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above by not having a working smoke detector and carbon monoxide detector, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 10/28/2025
Plan of Correction
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The licensee stated she will install new batteries in the smoke and carbon monoxide detectors and provide video verification to the SDRO by 10/28/2025.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Jason Garay
NAME OF LICENSING PROGRAM MANAGER:
Victoria Felix
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/23/2025


LIC809 (FAS) - (06/04)
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