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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215866
Report Date: 07/31/2023
Date Signed: 07/31/2023 02:29:01 PM

Document Has Been Signed on 07/31/2023 02:29 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: 51CENSUS: 9DATE:
07/31/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Esperanza CorreaTIME COMPLETED:
02:15 PM
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On 7/31/2023 at 11:32 AM, Licensing Program Analysts (LPAs), Martina Jimenez and German Negrete conducted a case management - deficiencies inspection for the purpose to follow up on the inspection conducted on 7/21/2023.

LPAs met with Esperanza Correa, licensee, the purpose of this inspection. LPAs observe three (3) infants, (6) children in the home at the time of the inspection. LPAs toured the FCCH inside and out.


This inspection will continue on a later date.

Exit interview and report was reviewed with Esperanza Correa, licensee. Notice of site visit was provided and must remain posted for the next 30 days.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 07/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/31/2023
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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