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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376621216
Report Date: 06/24/2025
Date Signed: 06/24/2025 04:02:02 PM

Document Has Been Signed on 06/24/2025 04:02 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:MUJICA, LORENA FAMILY CHILD CAREFACILITY NUMBER:
376621216
ADMINISTRATOR/
DIRECTOR:		LORENA MUJICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 250-2130
CITY:NATIONAL CITYSTATE: CAZIP CODE:
91950
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
06/24/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Lorena MujicaTIME VISIT/
INSPECTION COMPLETED:
04:10 PM
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On 06/24/2025 at 12:30 PM, Licensing Program Analyst (LPA), Oscar Picazo conducted an unannounced Annual/Random inspection and met with licensee Lorena Mujica. 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 9 day care children present at the time of this inspection, four (4) of which are infants. Also present during the inspection is Licensee's assistant, Malia Sokona. Licensee accompanied LPA throughout the inspection of this single story 4 bedroom, 2 bathroom home. The following areas are used for child care: Day care room, kitchen, dining area, Family room, hall bathroom #2 and the fully fenced east side yard. Off-limits areas are: Master bedroom 1 including bathroom #1, bedrooms 2,3 & 4, the garage, north backyard and swimming pool. These areas are made inaccessible with door knob covers, child barrier safety gates, locked doors and or are fully fenced. Hours of Operation are Monday- Friday, 6:30 AM - 4:30 PM.

The fireplace in the family room is screened. The fire extinguisher is rated 3-A:40-B:C and is mounted on the wall in the dining room, smoke and carbon monoxide detectors met requirements, were tested and are operational. Poisons, detergents, cleaning compounds and other hazardous items are locked and made inaccessible. The home has a fenced east side yard that is used for outdoor play and activity. Licensee stated she and her assistant provide direct supervision at all times when children are conducting any outside activities. Licensee has an ample amount of children's toys, age appropriate outdoor play equipment, books, and non-toxic child safe arts & crafts materials available.

See LIC 809C Continuation...

NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Oscar Picazo
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/24/2025
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: MUJICA, LORENA FAMILY CHILD CARE
FACILITY NUMBER: 376621216
VISIT DATE: 06/24/2025
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LPA observed one in- ground swimming pool in the north backyard of the facility that is off limits and locked at all times. The pool is fully fenced with pool fencing that consists of 15 sets of 2 - 4 sturdy mesh material panels that measure 5 feet (60") in height X 2.5 feet (30") width; with a vertical clearance of less than 1/2 an inch from the cement ground to the bottom of the enclosure, and no more than 1.5 inch gaps between each set of connecting panels and does not obscure the pool from view. There is 1 access door that has a key lockable, self-latching child proof safety device no lower than 60" above the ground, freely swings away from the pool without catching, self-latches from any distance it opens from and meets Tittle 22 regulation. LPA observed the lockable latch must be manually unlatched to open the gate. LPA observed and inspected safety equipment to meet Assembly Bill 2866 standards. LPA observed a pool alarm that complies with ASTM F2200 standards, a 17 in life ring approved by the US Coast Guard and safely pole with a body hook that extends beyond 12 feet. Licensee provided daily pool inspection logs for review.

The licensee has a working cell phone. 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. 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.

Licensee’s Mandated Reporter AB1207 training expires 06/2026. Pediatric CPR and First Aid certifications expire in 08/2025. The last fire and disaster drills were conducted and documented on 06/16/2025. Licensee and her husband Charlie Mujica own the property and maintain documentation of proof of control of property for review by the Department on hand. LPA viewed the current tax bill.

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.

See LIC 809C Continuation...

NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Oscar Picazo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
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: MUJICA, LORENA FAMILY CHILD CARE
FACILITY NUMBER: 376621216
VISIT DATE: 06/24/2025
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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 shel 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 provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms. 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, 06/24/2025, 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.

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.

No violations were cited during this inspection.

Exit interview was conducted and copy of this report was reviewed and provided to licensee, Lorena Mujica . Licensee stated she understood.

NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Oscar Picazo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2025
LIC809 (FAS) - (06/04)
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