Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 136609662
Report Date: 01/10/2017
Date Signed 01/10/2017 03:15:50 PM

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:LIZARRAGA, ELSA FAMILY CHILD CAREFACILITY NUMBER:
136609662
ADMINISTRATOR:ELSA LIZARRAGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 425-7883
CITY:CALEXICOSTATE: CAZIP CODE:
92231
CAPACITY:14CENSUS: 10DATE:
01/10/2017
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Elsa LizarragaTIME COMPLETED:
03:00 PM
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LPA Armando Locano completed an unannounced case management site inspection today regarding a self-reported incident from licensee, where a daycare parent adult #1 (see conf names list) told licensee that her child, toddler child # 1 (see conf names list) was not treated properly at the facility. Licensee stated that she provides proper direct supervision at all times and all children are always treated properly and such statement was not true.

LPA met with licensee, Elsa Lizarraga, 10 daycare children were present, all within ratios and 17 yr old helper. LPA discussed the incident with licensed and toured the facility and spoke to children. LPA explained that the issue will be reviewed further, before closing the issue.

A review of staff records on January 10, 2017 indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

There are no deficiencies cited, all paperwork is in order and the home has been properly childproofed.

A copy of this report shall be maintained in the facility for public review.
SUPERVISOR'S NAME: Carolina RamosTELEPHONE: (619) 767-2206
LICENSING EVALUATOR NAME: Armando LocanoTELEPHONE: (619) 767-2221
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2017
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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