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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376626037
Report Date: 03/26/2025
Date Signed: 03/26/2025 01:23:52 PM

Document Has Been Signed on 03/26/2025 01:23 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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME:GOMEZ, SILVIA FAMILY CHILD CAREFACILITY NUMBER:
376626037
ADMINISTRATOR/
DIRECTOR:		SILVIA GOMEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(442) 224-7152
CITY:VISTASTATE: CAZIP CODE:
92083
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
03/26/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:40 AM
MET WITH:Silvia Gomez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) William Chancellor conducted an unannounced annual inspection for a large family childcare at the above home on March 26, 2025, at 9:40AM. LPA met with Licensee (LIC) Silvia Gomez, who was conducting Circle Time upon arrival. To maintain supervision and ratios indoors, LIC authorized LPA to conduct an inspection independently indoors and outdoors. Upon arrival, LPA observed eight children present, including LIC and one assistant.

The facility operates Monday through Friday, 7AM- 5PM. Current ages served, include children three months to five years old. Certain areas are listed as off-limits, including the entire second floor, attached garage, side yard and extended garden behind the backyard retaining wall. The facility is licensed as a large Family Child Care Home (FCCH) with a maximum capacity of fourteen children and is operating within the licensed capacity on the license. The fire clearance for a large family childcare was approved on July 25, 2016, by Vista Fire Department.

During the inspection, LPA observed LIC conducting circle time in the main daycare area with seven children, and assistant 1 (A1) helping an infant going down for nap. LPA initiated a walkthrough of the home, indoors and out from 9:45AM-10:15AM. Licensee was observed to be redirecting children, interacting and following their lead while children independently engaged in different activities on individual activity mats. When outdoors, children were observed engaging in gross motor activities, such as bike riding and playing tag. Both licensee and assistant were observed interacting and supervising all eight children when outdoors. At approximately, 12 noon lunch was served on the covered patio outdoors.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2025
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 10
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
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GOMEZ, SILVIA FAMILY CHILD CARE
FACILITY NUMBER: 376626037
VISIT DATE: 03/26/2025
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LPA confirmed Licensee has a working cell phone and the current phone number on file is correct. A fully charged fire extinguisher (2A:10BC) was observed, mounted on the kitchen wall. Licensee had the Fire extinguisher serviced in March 2025 and a purchase receipt confirming purchase on March 10, 2025. LPA observed a functioning carbon monoxide detector mounted above the kitchen refrigerator. Additionally, LPA tested the smoke detector mounted near the steps and is in operating condition. Licensee confirmed all smoke alarms are electronically connected to addition smoke detectors throughout the home. LPA observed the fireplace is properly screened in the living room, with a mounted black wood cover. LPA discussed appropriately covering the outdoor fireplace, ensuring this fireplace is off-limits and inaccessible to daycare children during operating hours. LPA confirmed all child safety locks to off-limit areas are in working order, making hazardous items, including toxins, and medications locked and inaccessible to children.

Licensee, Silvia Gomez, stated weapons are not present in the home at this time. Licensee understands that all firearms, weapons, and ammunition must be locked separately and made inaccessible as per Title 22 Regulations. Licensee stated and LPA confirmed there are not any pools, spas, or other bodies of water present at the FCCH property at this time. Licensee understands that all bodies of water including ponds, above ground pools, spas, and some fountains must be properly covered or fenced per Title 22 Regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar products must be emptied immediately after use and stored in an upright position.

The facility provides a variety of age-appropriate toys for children. A current roster was available for review and up to date, during inspection. LPA confirmed the required postings, including the Facility Sketch, Emergency Disaster Plan, License and Notification of Parent’s Rights, are displayed on the porch at the front door or in the entry way of the home. Fire and disaster drill documentation is maintained, with the last drill being conducted and recorded on February 11, 2025.

Staff files were audited from 10:15- 10:27AM. Childrens files were audited from 10:27- 10:45AM. Both children's and employees' records were found to be complete, once children immunizations records were provided. Mandated Reporter Training has been completed and is valid until January 2027. Licensee Pediatric CPR and First Aid certification expired on March 25, 2025. However, assistant 1 (A1) had a current Pediatric CPR and First Aid certificate on file, expiring November 2026. LPA confirmed all residents of the home and staff, requiring caregiver background checks have received and are appropriately associated with necessary clearances and exemptions.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025
LIC809 (FAS) - (06/04)
Page: 8 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GOMEZ, SILVIA FAMILY CHILD CARE
FACILITY NUMBER: 376626037
VISIT DATE: 03/26/2025
NARRATIVE
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Licensee Silvia Gomez 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. LPA requested LIC to update, LIC 279 to list all children living in the home under the age of 18 years old. LPA reminded LIC that C1, must be fingerprinted once they turn 18 years old.

LPA discussed the safe sleep regulations with Licensee Silvia Gomez 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. LPA confirmed all infants, fifteen-minute sleep logs appropriately documented the position of the infant, under the age of 12 months, if on a position other than their back. A technical violation will be provided due to one infant, utilizing a sleep sack and clipped pacifier during nap. Please reference Advisory notes as needed.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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: https://www.ada.gov/resources/child-care-centers/

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

On-line Licensing forms & regulations for a Child Care Center can be obtained on the Department’s website: www.ccld.ca.gov. Additionally, there is a link to “Receive Important Updates” located on the right side of the page, immediately above Quick Links. One can add their email address and choose which program(s) they wish to receive Provider Information Notices (PIN) for.

NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025
LIC809 (FAS) - (06/04)
Page: 9 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE SE CC RO, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GOMEZ, SILVIA FAMILY CHILD CARE
FACILITY NUMBER: 376626037
VISIT DATE: 03/26/2025
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The Duty Officer is available to answer questions Monday – Friday; 8:00am to 5:00pm at: 951-782-4200. Unusual Incident Reports (UIR) must be called in within 24 hours and then electronically emailed or faxed within 7 business days at: unusualincidentreportsDO10@dss.ca.gov.

On this date, March 25, 2025, the California Attorney General - Megan’s Law website 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 improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process for CARE tools, please send the email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

There are no deficiencies being cited at this time. Please refence advisory notes, LIC 9102 to review regulations that were observed to be either in question or a potential risk for a future deficiency cited. The intent is to avoid issuing citations for violations that are technical in nature and do not present an immediate or potential health, safety or personal rights risk to those in care.



A Notice of Site Visit (NOS) was given and must remain posted for 30 consecutive days. LPA reminded licensee that NOS must be posted in a prominent, visible space available to parents, guardians or care givers.

An exit interview was conducted, and a copy of this this report was reviewed with Licensee, Silvia Gomez. Appeal rights were discussed and provided during the exit interview. Licensee stated they agreed for all forms to be electronically sent, due to FAS error at the end of LPA inspection.
NAME OF LICENSING PROGRAM MANAGER: Pauline Beschorner
NAME OF LICENSING PROGRAM ANALYST: William M Chancellor Jr.
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2025
LIC809 (FAS) - (06/04)
Page: 10 of 10