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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376630371
Report Date: 10/02/2026
Date Signed: 10/02/2026 04:12:58 PM

Document Has Been Signed on 10/02/2026 04:12 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:RODRIGUEZ, MAYRA & WILFREDO FAMILY CHILD CAREFACILITY NUMBER:
376630371
ADMINISTRATOR/
DIRECTOR:
MAYRA & WILFREDO RODRIGUEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 305-5400
CITY:CHULA VISTASTATE: CAZIP CODE:
91910
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 5DATE:
10/02/2026
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:26 PM
MET WITH:Mayra RodriguezTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
NARRATIVE
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On 10/02/2026 at 3:26PM Licensing Program Analyst (LPA), Saul Zazueta, Licensing Program Manager (LPM), Selina Siao and Regional Manager (RM), Jason Garay, conducted an unannounced case management inspection. Upon arrival, LPA met with Licensee, Mayra Rodriguez, and discussed the purpose of the inspection and was led on a tour of the facility. During the inspection there were five (5) children in care with two (2) staff members present.

During the course of an unrelated investigation, interviews were conducted with both licensees, facility staff, daycare parents and law enforcement representatives. Based on multiple interviews conducted, LPA determined that on multiple occasions, the licensees permitted minor Child #3 (C3) and minor Child #4 (C4) to supervise children without adult supervision. Also, it was found that licensees allowed C3 to transport children without adult supervision, on multiple occasions. Per California Code of Regulations, (Title 22, division 12 & Chapter 3), one (1) Type A deficiency is being cited on the attached LIC 9099-D. A Civil Penalty in the amount of $500 was assessed during today’s inspection.

LPA, Saul Zazueta, informed Licensee, Mayra Rodriguez, that this report, dated 10/02/2026, documents one (1) Type A citation, which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA, Saul Zazueta, informed the Licensee, Mayra Rodriguez, to provide a copy of this licensing report dated 10/02/2026 that documents Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
Selina Siao
Saul Zazueta
DATE: 10/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2026
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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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: RODRIGUEZ, MAYRA & WILFREDO FAMILY CHILD CARE
FACILITY NUMBER: 376630371
VISIT DATE: 10/02/2026
NARRATIVE
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Exit interview was conducted and this report was reviewed with Licensee, Mayra Rodriguez. A Notice of Site Visit was provided and must remain posted for 30 days.
NAME OF LICENSING PROGRAM MANAGER: Selina Siao
NAME OF LICENSING PROGRAM ANALYST: Saul Zazueta
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/02/2026 04:12 PM - It Cannot Be Edited


Created By: Saul Zazueta On 10/02/2026 at 07:51 AM
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: RODRIGUEZ, MAYRA & WILFREDO FAMILY CHILD CARE

FACILITY NUMBER: 376630371

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 10/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/03/2026
Section Cited
CCR
102417(a)

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102417 Operation of a Family Child Care Home (a)The licensee shall be present in the home and shall ensure that children in care are supervised at all times […]. This requirement is not met as evidenced by:
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Licensee stated... A Temporary Suspension Order (TSO) was served on October 2, 2026. Licensee is prohibited from operating a family childcare home at this location effective October 2, 2026 at 6:00PM.
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Based on interviews, the licensees did not comply with the section cited above in that they permitted minor(s) to supervise children alone on multiple occasions, which poses an immediate health, safety, and personal rights risk to children in care.
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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.
Selina Siao
NAME OF LICENSING PROGRAM MANAGER:
Saul Zazueta
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 10/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/02/2026


LIC809 (FAS) - (06/04)
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