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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215866
Report Date: 10/06/2023
Date Signed: 10/06/2023 10:54:46 AM

Document Has Been Signed on 10/06/2023 10:54 AM - 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: 11DATE:
10/06/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Esperanza CorreaTIME COMPLETED:
09:05 AM
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On October 6, 2023, at 9:05 AM, Licensing Program Analysts (LPAs) Francisca Velazquez and Elvin Baddley conducted an unannounced Case Management – Legal inspection. LPAs met with licensee, Esperanza Correa and discussed the purpose of the inspection. LPAs and Licensee toured the interior and exterior of the home. LPAs observed 11 children present and 4 adults present during the inspection. Licensee was not home and arrived 10 minutes from the time LPAs initiated this inspection.

The purpose for this inspection is to deliver the Accusation CDSS No. 6423215103.

A copy of the Accusation Summary indicates the Departments intent of License Revocation. A copy of this Accusation shall be provided to the parent/guardian of currently enrolled child by the next business day or immediately upon return as well as the parent/guardian of any enrolled child until the accusation is either dismissed or resolved through the administrative hearing or stipulated agreement. The following documentation was provided and explained:

· Accusation
· Acknowledgement of Receipt of Licensing Reports (LIC 9224)

A Notice of Site Visit was issued. Appeal Right were given to Licensee.

Exit interview was conducted and report was reviewed with Licensee, Esperanza Correa in Spanish.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2023
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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