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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376617294
Report Date: 03/22/2021
Date Signed: 03/22/2021 10:10:51 AM

Document Has Been Signed on 03/22/2021 10:10 AM - 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:CERON, LETICIA FAMILY CHILD CAREFACILITY NUMBER:
376617294
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
03/22/2021
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Leticia CeronTIME COMPLETED:
10:05 AM
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On March 22, 2021 at 8:15 AM, Licensing Program Analyst (LPA) Jo Ann Legaspi conducted an unannounced case management inspection. Language Link Operator 13458 provided Spanish translation services. LPA advised Licensee of the meeting’s purpose. Due to the COVID 19 outbreak, this inspection was done as a tele visit via the What's App platform. Present in the daycare were one (1) daycare toddler, and one (1) school aged child, the Licensee and a helper. The facility was toured.

On 03/18/2021, it was alleged that the Licensee's related child was threatened and hit in the presence of daycare children. During this visit, LPA interviewed the Staff 1 and Child 1 - 2. See LIC 811 Confidential Names. Child 2 was unable to provide a statement due to their development limitation.

The Licensee agreed to electronically provide LPA with the LIC 9040 Child Care Roster no later than Monday, 04/05/2021.

Licensee and LPA reviewed Title 22 CCR 102423, which describes the legal personal rights of children in care. The Licensee expressed they understood the contents of this code section. LPA electronically provided Licensee with Title 22 CCR 102423.

Due to current insufficient information, the incident requires further investigation before findings may be rendered. No deficiencies were cited.

A Notice of Site Visit (LIC 9213) is to be posted for thirty (30) days. LPA will electronically provide this document to the Licensee. An exit interview was conducted. A copy of this report and Licensee/Appeal Rights (LIC 9058) will be e-mailed to the Licensee. The Licensee was advised that acknowledgement of the receipt of the report is to be received within twenty-four hours.
SUPERVISORS NAME: Tulam Vu
LICENSING EVALUATOR NAME: JoAnn R Legaspi
LICENSING EVALUATOR SIGNATURE: DATE: 03/22/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/22/2021
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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