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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136610081
Report Date: 08/02/2024
Date Signed: 08/02/2024 01:47:56 PM

Document Has Been Signed on 08/02/2024 01:47 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:CANO, ROSE FAMILY CHILD CAREFACILITY NUMBER:
136610081
ADMINISTRATOR/
DIRECTOR:		ROSE CANOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 595-1752
CITY:EL CENTROSTATE: CAZIP CODE:
92243
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 4DATE:
08/02/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:15 AM
MET WITH:Kimberly EspinozaTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
NARRATIVE
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***This is an amended version of the report that was created on 05/14/2024***

On 8/2/24 at 11:15 AM, Licensing Program Analyst (LPA) Gloria Gonzalez conducted an unannounced case management inspection to deliver an amended report originally created on 5/14/24. Upon arrival, LPA met with Helper, Kimberly Espinoza and proceeded to tour the facility.  On or about 11:30 AM Licensee, Rose Cano arrived at the facility and continued the inspection with LPA.

There were four (4) children, including one (1) infant and two (2) staff members present, during today’s inspection. 

Licensee did not provide evidence of a current tuberculosis clearance, not more than one year prior to or seven days after initial presence in the home,  for adult #1 that is residing in the home.

A Type B deficiency is being cited. See LIC809D.

Exit interview was conducted with Licensee, Rose Cano.  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: Tulam Vu
LICENSING EVALUATOR NAME: Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2024
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 08/02/2024 01:47 PM - It Cannot Be Edited


Created By: Gloria Gonzalez On 08/02/2024 at 12:09 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: CANO, ROSE FAMILY CHILD CARE
FACILITY NUMBER: 136610081

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/20/2024
Section Cited
CCR
102369(b)(9)

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102369(b)The applicant shall provide all of the following information ... (9) Evidence of a current tuberculosis clearance..., for any adult in the home during the time that children are under care. This requirement was not met as evidenced by:
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Licensee states she will have Adult #1 submit a TB Clearance to the Department by 5/20/24 by email. Licensee states she will submit in writing her understanding of this regulation and how she will comply in the future.
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Based on interview the licensee did not ensure evidence of a current tuberculosis clearance.., for Adult #1 in the home during the time that children are under care.….which poses a potential Health and,Safety risk to persons in care.
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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:Tulam Vu
LICENSING EVALUATOR NAME:Gloria Gonzalez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2024


LIC809 (FAS) - (06/04)
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