<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 370810018
Report Date: 02/25/2025
Date Signed: 02/25/2025 01:57:08 PM

Document Has Been Signed on 02/25/2025 01:57 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:AGNEW, ROSA M. FAMILY CHILD CAREFACILITY NUMBER:
370810018
ADMINISTRATOR/
DIRECTOR:		AGNEW, ROSA M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
6192922004
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 14TOTAL ENROLLED CHILDREN: 10CENSUS: 7DATE:
02/25/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Rosa M AgnewTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 02/25/2025, at 8:30AM, Licensing Program Analyst (LPA), Oscar Picazo conducted an unannounced Required - 3 Year inspection and met with licensee Rosa Agnew. Upon arrival, LPA was greeted and granted entry into the facility by Licensee. LPA disclosed the purpose of the inspection and was granted permission to tour the facility by the Licensee. The tour was led by the licensee. The purpose of the inspection is to ensure the home is in compliance with the standards established in CCR, Title 22, Division 12, Chapter 3, for Family Child Care Homes. There were 7 day care children present at the time of this inspection of which 1 is an infant. Also present during this inspection is Licensee's assistant, Maria Luz Arriaga. Licensee accompanied LPA throughout the inspection of this single story, 4 bedroom, 3 bathroom home. The following areas are used for child care: Living room, Class/Play room, baby room, hallway bathroom, rear patio and back yard. Off-limits areas are: The kitchen, dinning area bedroom 2 which includes bathroom 2, the Master bedroom which includes bathroom 3, the study room (converted garage), the drive way, the front and side yards. These areas are made inaccessible with safety gates, door knob covers, cabinet locks and latching gates. The back yard is used for outdoor activities, licensee stated total supervision is provided. Days and hours of operation are Monday through Friday 5:00 AM – 6:00 PM.

The fire extinguisher is rated 3-A:40-B:C and is mounted in the hallway closet, smoke and carbon monoxide detectors meet requirements and are operational. Poisons, detergents, cleaning compounds and other hazardous items are locked and made inaccessible. Licensee has an ample amount children's toys, play equipment and books available. The licensee has a working cell phone. No bodies of water observed on the premises during the inspection. Applicant 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.

See LIC 809C Continuation...

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Oscar Picazo
LICENSING EVALUATOR SIGNATURE: DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/25/2025
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 4
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: AGNEW, ROSA M. FAMILY CHILD CARE
FACILITY NUMBER: 370810018
VISIT DATE: 02/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Facility roster is maintained and was reviewed. LPA reviewed children’s files. Children’s files reviewed were complete and met regulations.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

Licensee’s Mandated Reporter AB1207 training is expired. Pediatric CPR and First Aid certifications are expired. The last fire and disaster drills were conducted and documented on 012/17/2025. Licensee owns the home and Proof of ownership (mortgage statement) was viewed and verified during the inspection.

Incidental Medical Services (IMS) policy was reviewed. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Licensee was advised if there is to be an infant in care, there must be one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. Licensee physically checks on sleeping infants up to 24 months of age every 15 minutes. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age. Licensee states she places infants up to 12 months of age on their backs for sleeping. 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 reviewed the safe sleep regulations with licensee. Child Care Licensing Safe Sleep webpage: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms.

See LIC 809C Continuation...

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Oscar Picazo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: AGNEW, ROSA M. FAMILY CHILD CARE
FACILITY NUMBER: 370810018
VISIT DATE: 02/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided information regarding SIDS, Lead exposure and Shaken Baby Syndrome.

On this date, 02/25/2025, the California Attorney General - Megan’s Law website (meganslaw.ca.gov) was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Southern California Child Care Advocate information was provided, and applicant was encouraged to subscribe through the CCLD website to be placed on an email list for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

A copy of this report and notice of site visit (LIC9213) was provided to the Licensee and was advised it must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Deficiencies cited can be found on the attached LIC 809D page.

Exit interview conducted and copy of report was provided to licensees, Rosa Agnew. LPA O. Picazo is bilingual certified and translated this report in Spanish. Licensee stated she understood.

SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: Oscar Picazo
LICENSING EVALUATOR SIGNATURE:

DATE: 02/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2025
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 02/25/2025 01:57 PM - It Cannot Be Edited


Created By: Oscar Picazo On 02/25/2025 at 12:37 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: AGNEW, ROSA M. FAMILY CHILD CARE
FACILITY NUMBER: 370810018

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/25/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 2 staff which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/11/2025
Plan of Correction
1
2
3
4
Licensee states that she and her assistant will complete and renew their AB1207 Mandated Reporter training and submit verification to the LPA by via walk-in or email by 03/11/2025.
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation and record review, the licensee did not comply with the section cited above in 2 out of 2 staff which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/11/2025
Plan of Correction
1
2
3
4
Licensee states that she and her assistant will complete and renew their CPR and First aid recertification training by the 03/11/25 and submit verification to the LPA by via walk-in or email by 03/11/2025.
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:Oscar Picazo
LICENSING EVALUATOR SIGNATURE:
DATE: 02/25/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/25/2025


LIC809 (FAS) - (06/04)
Page: 4 of 4