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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376629520
Report Date: 02/03/2026
Date Signed: 02/03/2026 02:53:28 PM

Document Has Been Signed on 02/03/2026 02:53 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:LOPEZ AVILA, LAURA FAMILY CHILD CAREFACILITY NUMBER:
376629520
ADMINISTRATOR/
DIRECTOR:		LAURA LOPEZ AVILAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 551-3971
CITY:SAN YSIDROSTATE: CAZIP CODE:
92173
CAPACITY: 14TOTAL ENROLLED CHILDREN: 19CENSUS: 3DATE:
02/03/2026
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:30 PM
MET WITH:Jessica BetlranTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On February 03, 2026 at 2:30 PM Licensing Program Analyst (LPA), Gloria Gonzalez conducted an unannounced inspection to open a complaint. Upon arrival, LPA met with Staff #1 (S1), Jessica Beltran and disclosed the purpose of the inspection. During the inspection there were three (3) daycare children and one (1) other staff member (S2).
 
LPA reviewed the facility roster and S2 is not on the roster. Licensee submitted a copy of a clearance letter for S2 by phone to S1 from another facility. Licensee advised S1 that the transfer documents were submitted on 01/26/2026, but did not say where or how. S2 stated S1 has been working at this facility for about 2 weeks.
 
A Type B deficiency is being cited during today's inspection, see LIC809D.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with S2, Jessica Beltran.
NAME OF LICENSING PROGRAM MANAGER: Tulam Vu
NAME OF LICENSING PROGRAM ANALYST: Gloria Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/03/2026
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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Document Has Been Signed on 02/03/2026 02:53 PM - It Cannot Be Edited


Created By: Gloria Gonzalez On 02/03/2026 at 02:16 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: LOPEZ AVILA, LAURA FAMILY CHILD CARE
FACILITY NUMBER: 376629520

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/04/2026
Section Cited
CCR
102370(d)(2)

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102370 (d)All individuals subject to a criminal record review...shall prior to working...in a licensed facility: (2)Request a transfer of a criminal record clearance as specified in Section 102370(j)...
This requirement is not met as evidenced by:
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S1 called Licensee and Licensee stated that the criminal record clearance request to transfer S2 was submitted on 01/26/26 but did not say where or how. LPA advised that the facility roster was printed on todays date of 02/03/2026 and S2 is not on the roster. Licensee submitted to S1 a copy of
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Based on observation, and record review, the licensee did not comply with the section cited above by not ensuring S1's clearance was transferred to this facility, as S1 was not listed on the facility roster, which poses a potential Health and, Safety and/or Personal Rights risk to persons in care.
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clearance letter at a different facility. Licensee shall submit the LIC9182 to transfer criminal record clearance for S2 by 02/04/2026 and her plan of correction on how she will ensure all staff is criminal record cleared prior to working at the facility by email.

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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.
Tulam Vu
NAME OF LICENSING PROGRAM MANAGER:
Gloria Gonzalez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 02/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/03/2026


LIC809 (FAS) - (06/04)
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