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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215866
Report Date: 08/14/2023
Date Signed: 08/14/2023 05:13:26 PM

Document Has Been Signed on 08/14/2023 05:13 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: 39CENSUS: 25DATE:
08/14/2023
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
06:30 AM
MET WITH:Esperanza CorreaTIME COMPLETED:
05:35 PM
NARRATIVE
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Licensing Program Analysts (LPAs) Martina Jimenez and German Negrete, conducted a case management inspection and met with Esperanza Correa, licensee, Vishnu Garcia, assistant, Ashley Correa, Assistant, Daniela Flores Reyna, Assistant and Esperanza Correa, assistant/mother, who was sleeping in the upstairs bedroom.

LPAs observed at 6:25am, licensee, three children and one (1) infant boarding a Mazda XC5. LPAs observed Vishnu Garcia, assistant, boarding a white van with two (2) school age children.

The licensee was informed the reason for the visit. LPA Jimenez with the licensee toured the home together inside and outside. LPAs observed four (4) infants, six (6) children ages 2-5 years old and fifteen (15) school age children in care at the time of the inspection.

LPA Jimenez interview with the licensee, and review of the children's files revealed that a copy of the Non-compliance Report (LIC9111), for August 7, 2023, has not been provided to the parents/guardians of the children in care, nor has the acknowledgement of receipt of Licensing Reporter (LIC9224) for reports, dated August 7, 2023, have not been provided to parents/guardians of the children in care, nor signed LIC 9224.

This Report Continues on LIC 809C & LIC 809D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2023
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: 08/14/2023
NARRATIVE
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Today’s visit was conducted in Spanish. Today, deficiency cited under Title 22 Division 12 Spanish 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: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/14/2023 05:13 PM - It Cannot Be Edited


Created By: Martina Jimenez On 08/14/2023 at 12:58 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: 08/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2023
Section Cited
CCR
102416.5(d)

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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.
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Licensee agrees to review children schedules to ensure she maintains capacity's 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 future incident to CCLD by 8/15/23, via email; [email protected]
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This requirement was not met as evidence by LPAs observed on 8/14/23, four (4) infants, six (6) children ages 2-5 years old and fifteen (15) school age children in care, this is an immediate health and safety risk to the children in care.
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Repeat violation - the facility was cited on 7/212023. A civil penalty of $250.00 was assessed for repeat violation.

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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: 08/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/14/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/14/2023 05:13 PM - It Cannot Be Edited


Created By: Martina Jimenez On 08/14/2023 at 01:41 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: 08/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/18/2023
Section Cited
HSC
1596.8595(c)(1)

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A licensed child day care facility shall provide to the parents or guardians of each child receiving services in the facility copies of any licensing report that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b
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Licensee agreed to provide copies of this licensing report to each parent/guardian of enrolled children and to parents/guardians of newly enrolled children during the next 12 months. Plan of correction letter will be submitted to CCLD no later 8/18/2023, via email: [email protected]
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This requirement is not met as evidence by: LPA review of children's record revealed that Type A Non-Compliance Report issued on 8/7/2023 was not provided to parents and LIC 9224 (Acknowledgement Form) was not in the children's file. This poses a potential risk to health and safety of 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: 08/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/14/2023


LIC809 (FAS) - (06/04)
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