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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376608782
Report Date: 01/10/2024
Date Signed: 01/10/2024 05:16:56 PM

Document Has Been Signed on 01/10/2024 05:16 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:RIVAS, ROSA & FAUSTO FAMILY CHILD CAREFACILITY NUMBER:
376608782
ADMINISTRATOR:ROSA RIVASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 475-4686
CITY:SAN DIEGOSTATE: CAZIP CODE:
92139
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/10/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
04:15 PM
MET WITH:Rosa RivasTIME COMPLETED:
05:20 PM
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On this date and time, Licensing Program Analyst (LPA) Adrian Castellon arrived at facility to conduct a Case Management visit to follow-up on a Notice to Cease Operation letter which was hand delivered and discussed with licensee on 12/22/23.

During today’s inspection LPA Castellon met with Licensee, Rosa Rivas. Co-Licensee, Fausto Rivas was not present in the home. This inspection was conducted in Spanish per licensee's request. LPA toured the facility. There were no children present.

On this date, LPA discussed license options with licensee. LPA advised licensee that license could be surrendered but that department may continue with any current or future proceedings. LPA also discussed Inactive Status process. Licensee wishes to keep license open at this time.

Licensee was advised if they had any questions regarding the Notice to Cease Operation, they may contact the office at (619) 767-2200 and ask to speak with LPA Castellon and/or management.

Exit interview was conducted and report was reviewed with Licensee, Rosa Rivas. A Notice of Site Visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Cynthia Gray
LICENSING EVALUATOR NAME: Adrian Castellon
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2024
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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