<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215866
Report Date: 07/21/2023
Date Signed: 07/24/2023 04:25:39 PM

Document Has Been Signed on 07/24/2023 04:25 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CORREA FAMILY CHILD CAREFACILITY NUMBER:
426215866
ADMINISTRATOR:ESPERANZA CORREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 268-1854
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 20DATE:
07/21/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Esperanza CorreaTIME COMPLETED:
07:50 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
THIS IS AN AMENDED REPORT FOR INSPECTION CONDUCTED ON 7/21/2023
Licensing Program Analyst (LPA) Martina Jimenez conducted a case management visit and met with Esperanza Correa, licensee, Lilianna Milagros, assistant, and Esperanza Correa, assistant/mother. LPA observed at 2:17pm, Vishnu Garcia, licensee's adult son arrived to the FCCH.

The licensee was informed the reason for the visit. The home was toured inside and outside. LPAs observed four (4) infants, nine (9) children ages 2-5 years old and seven (7) school age children in care at the time of the inspection.

LPA observed Lilianna Milagros at 1:56pm, kitchen sweeping. LPA approached Ms. Milagros and asked Ms. Milagros why she left in a hurry yesterday when LPA arrived to the FCCH? Ms. Milagros stated I knew that I was not suppose to be here, I got scared and left. LPA requested Ms. Milagros identification card or driver license. Ms. Milagros provided LPA with an identification card from El Salvador. LPA asked Ms. Milagros if the criminal record clearance was completed? Ms. Milagros stated no and left through the front door.

On 7/20/2023, LPAs observed three (3) infants, seven (7) children ages 2-5 years old and four (4) school age children in care at the time of the inspection. LPAs Martina Jimenez and German Negrete, arrived to the FCCH at 3:05pm. LPA Jimenez upon entering the FCCH, LPA Jimenez observed an infant (C1) strapped in the car seat. LPA Jimenez advised the licensee it is prohibited to have an infant in the car seat strapped in.

LPA Jimenez observed Lilian Milagros, Assistant, exiting the FCCH through the back sliding door in a
This Report Continues on LIC 809C & LIC 809D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2023
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426215866
VISIT DATE: 07/21/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
hurry. LPA turned and followed Ms. Milagros. Once in the backyard LPA called out to Ms. Milagros. Ms. Milagros continued walking, reached over the fence opened the side of the fence and left through the fence. The fence has a section that opens on the to the adjoining property/neighbor.

The licensee was left alone caring for two (2) infants, eight (8) children ages 2-5, and four (4) school age children. The licensee called Ashley Correa, assistant/daughter arrived to the FCCH at 3:25pm, to assist licensee with the children in care. The licensee's daughter, Alyssa Correa, arrived to the FCCH at 5:00 to assist licensee in caring for the children.

When Ashley Correa, arrived to the FCCH at 3:25pm, Ms. Ashley stated "I was here assisting my mom, but I left to go pick up kids from school and take them home. LPA asked Ms. Ashley for her driver license. Ms. Ashley stated I don't have one. LPA asked Ms. Ashley, are you driving without a driver's license? Ms. Ashley stated "no I walked to the school and walked the children home. LPA asked what school did you go pick up the children? Ms. Ashley Correa, replied Tyler elementary.
Licensee stated it's summer school to Sanchez Elementary. Ms. Ashley stated that she leaves the licensee with fourteen children while Ms. Ashley walks to Tyler Elementary, waits for the brother-in-law picks up C6 from Sanchez Elementary, drops off C6 at Tyler Elementary and Ms. Ashley then walks C6 home. LPA asked how far is Tyler Elementary? Ms. Ashley stated it's 3 blocks away.

LPA asked Ashley Correa, how long has she been an assist for Correa FCCH? Ashley Correa, stated since she was seventeen (17) years old. LPA advised Ashley Correa that she had 30 days from her date of birth to complete the criminal record clearance and tuberculosis test, and it has been over 3 years now.

LPAs reviewed the facility roster through LIS and Guardian, which revealed that Lilian Milagros and Ashley Correa do not have a criminal record clearance. LPA advised Ms. Ashley Correa and Esperanza Correa, that Ashley Correa should not be employed, volunteer or reside in the FCCH prior This Report Continues on LIC 809C & LIC 809D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426215866
VISIT DATE: 07/21/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
to obtaining a criminal record clearance.

LPAs toured the home inside and out. LPA Jimenez observed the safety gate to the kitchen near the stairs was opened at 3:52pm. LPAs and the licensee enter the kitchen, LPA Jimenez observed a large knife on the kitchen counter accessible to children in care.

LPAs requested the files of the fourteen (14) children in care. The licensee stated that she did not have file for C1, C2, C3, C4. & C5.

Today’s visit was conducted in Spanish. Today, deficiency cited under Title 22 Division 12 Appeal rights given. Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

LPA observed licensee post the Notice of Site visit FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY. THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6
Document Has Been Signed on 07/21/2023 07:38 PM - It Cannot Be Edited


Created By: Martina Jimenez On 07/21/2023 at 04:30 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426215866

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2023
Section Cited
CCR
102370(d)(1)

1
2
3
4
5
6
7
The following CCR, Title 22, Division 12 regulation was cited: 102370 (d)(1) Criminal Record Clearance. All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption....
1
2
3
4
5
6
7
Ms. Ashley Correa and Ms. Lilianna Milagros must get a criminal record clearance and submit all documents to the Community Care Licensing (CCL by 7/24/2023. A $500 civil penalty was assessed for Ms. Ashley Correa and Ms. Lilianna Milagros). POC will be office visit
8
9
10
11
12
13
14
Department or This requirement is not met as evidence by: Based on LPA's review of the facility, interviews, the licensee, Ms Ashley Correa, and Ms. Lilianna Milagros stated that Ms.Ashley Correa, has been assisting in the FCCH since October 2019. Ms. Lilianna Milagros has been assisting in the FCCH since May 2023. They have not obtained a criminal record clearance. This poses an immediate risk to health and safety of children in care.
8
9
10
11
12
13
14
Type A
07/24/2023
Section Cited
CCR102417(g)(4)

1
2
3
4
5
6
7
102417(g)(4)(A) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: Poisons, detergents, cleaning compounds, medicines, firearms and ...a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee will submit a written POC on how licensee will prevent future incidents from occurring to CCLD by 7/24/2023. POC will be office visit
8
9
10
11
12
13
14
LPAs observed a large knife on the kitchen counter accessible to children in care. This poses an immediate risk to health and safety of children in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Martina Jimenez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document is an Amendment of Original Document on 07/24/2023 02:18 PM


Created By: Martina Jimenez On 07/21/2023 at 05:29 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426215866

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2023
Section Cited
CCR
102425(h)

1
2
3
4
5
6
7
102425(h) Infant Safe Sleep- Car seats shall only be used for transportation purposes and shall not be used for sleeping. This requirement was not met as evidence by: LPA observed an infant (C1) strapped in the car seat. This is an immediate health and safety risk to the children in care.
1
2
3
4
5
6
7
Licensee will submit a written plan explaining how she will ensure that infants are not placed in car seats for any reason other than transportation. Plan will be submitted via email to [email protected] by 7/24/23. POC office visit
Type A
07/24/2023
Section Cited
CCR
102416.5(d)

1
2
3
4
5
6
7
For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met.
1
2
3
4
5
6
7
Licensee agrees to review children schedules to ensure she maintains capacities at all times. Licensee will not except children once licensee reached the license capacity. Licensee will submit a written POC on how licensee will prevent furture incident to CCLD by 7/24/23. POC office visit
8
9
10
11
12
13
14
 This requirement was not met as evidence by LPA observed on 7/20/2023 observed licensee alone for 1 hour and fifty-five minutes caring for children of which 3 infants, 7 children, (2-5 yrs old) & 4 school age. This is an immediate health and safety risk to the children in care.
8
9
10
11
12
13
14
Repeat violation - the facility was cited on 2/8/2023. A civil penalty of $250.00 was assessed for repeat violation.
Type A
07/25/2023
Section Cited
CCR
102416(f)

1
2
3
4
5
6
7
The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children. This requirement was not met as evidence LPA observed licensee caring 20 children in care on 7/21/2023. This is an immediate health and safety risk to the children in care.
1
2
3
4
5
6
7
Licensee agrees to review children schedules to ensure she maintains capacities at all times. Licensee will not except children once licensee reached the license capacity. Licensee will submit a written POC on how licensee will prevent furture incident to CCLD by 7/24/23. POC office visit
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Martina Jimenez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023


LIC809 (FAS) - (06/04)
Page: 5 of 6
Document Has Been Signed on 07/21/2023 07:38 PM - It Cannot Be Edited


Created By: Martina Jimenez On 07/21/2023 at 06:19 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426215866

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/28/2023
Section Cited
CCR
102425(c)

1
2
3
4
5
6
7
Children's Records
The licensee shall maintain, in each child's record....
This requirement was not met and evidenced by: Review of children's files revealed C1, C2, C3, C4 & C5 did not have a files. This poses a potential risk to the Health and Safety of Children in care.
1
2
3
4
5
6
7
Licensee will submit copies of the children's file and a written POC on how licensee will prevent future incidents to CCLD by 7/28/2023. Via email:
[email protected]
POC office visit

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Martina Jimenez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/21/2023


LIC809 (FAS) - (06/04)
Page: 6 of 6