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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215866
Report Date: 08/01/2023
Date Signed: 08/01/2023 02:43:36 PM

Document Has Been Signed on 08/01/2023 02:43 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: 57CENSUS: 9DATE:
08/01/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:06 AM
MET WITH:Esperanza Correa TIME COMPLETED:
02:50 PM
NARRATIVE
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On August 1, 2023, at 10:06 AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management - Deficiencies inspection, for the inspection conducted on 7/31/2023. LPA met with Esperanza Correa, licensee, and explained the purpose of the inspection which was to complete the inspection from 7/31/2023.

LPA observed Licensee's mother, Esperanza Correa come downstairs at 7:03 AM, and Liliam Torres Milagros, assistant arrived to the FCCH 8:10 AM. LPA observed two infants and seven (7) children in care at the time of the inspection.

On 7/31/2023, 11:49 AM, LPAs Velasquez and Baddley observed twenty-nine (29) children at Waller Park, with no food or water available to the twenty-nine children. The adults present caring for the children at Waller Park were Ashley Correa, Jesus Puga Sanchez, Liliam Torres Torres, and Daniela Flores Reyes.

At the time of the inspection, Esperanza Correa, was cited an immediate civil penalty of $250.00 for over Capacity, repeat violation was assessed for 07/21/2023, 07/31/2023 and 08/01/2023.

Today’s visit was conducted in Spanish by LPA Jimenez. This report was translated in Spanish byLPA Jimenez. Today, deficiency cited under Title 22 Division 12, Spanish Appeal rights provided to licensee.


This Report Continues on LIC 809C & LIC 80D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2023
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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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: 08/01/2023
NARRATIVE
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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 9099 and LIC 9099 D.


LPA provided the Licensee a Notice of Site (LIC 9213) visit which was posted in the LPA's presence. this REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2023
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Document Has Been Signed on 08/01/2023 02:43 PM - It Cannot Be Edited


Created By: Martina Jimenez On 08/01/2023 at 11:21 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426215866

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/02/2023
Section Cited
CCR
102416.5(d)

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(d) For a Large FCCH, the maximum number of children for whom care may be provided at any one time when there is an assistant...(1)Twelve children, no more than four of whom may be infants; or (2) More than twelve and up to fourteen children if the criteria in Section 1597.465 of the Health & Safety Code are met.
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Licensee will submit a written POC on how licensee will prevent future incidents from occurring to CCLD by 8/2//2023, via email: [email protected]

POC will be office visit
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LPAs observation reveal that Licensee cared for more than fourteen (14) at once during 7/21/2023, 7/31/23 and 8/1/2023. This poses an immediate risk to health, safety or personnel rights of persons in care.
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Type A
08/02/2023
Section Cited
CCR102423(a)(1)

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Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (1)To be
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Licensee will submit a written POC on how licensee will prevent future incidents from occurring to CCLD by 8/2//2023, via email: [email protected]

POC will be office visit
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treated with dignity in his/her personal relationship with staff and other persons.
This regulation was not met by there was no food or water available to the 29 children in care at the park. This posses an immediate health and safety 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.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Martina Jimenez
LICENSING EVALUATOR SIGNATURE:
DATE: 08/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/01/2023


LIC809 (FAS) - (06/04)
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