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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 364843612
Report Date: 12/26/2023
Date Signed: 04/09/2024 03:43:00 PM


Document Has Been Signed on 04/09/2024 03:43 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, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551



FACILITY NAME:TERRAZAS FAMILY CHILD CAREFACILITY NUMBER:
364843612
ADMINISTRATOR:DELIA TERRAZASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 977-0095
CITY:HESPERIASTATE: CAZIP CODE:
92344
CAPACITY:14CENSUS: 3DATE:
12/26/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
09:33 AM
MET WITH:Delia TerrazasTIME COMPLETED:
10:26 AM
NARRATIVE
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On 12/26/2023 at 9:35 AM, Licensing Program Analysts (LPAs) Carol Heath and Crystal Ali initiated a complaint investigation at the Terrazas Family Child Care Home and met with the Licensee, Delia Terrazas. The purpose of the inspection was to inform the Licensee that an investigation is being conducted regarding the above allegation. There are 4 adults living in the house (Licensee, Licensee’s husband, 2 adult sons). LPA observed 2 foster children and 1 childcare child (one 4 years old, one 14 months old and 2 years old) with the licensee and her husband (See LIC 811) present during today’s inspection.

During today's inspection, the licensee's foster adult grandson is not associated with the facility (See LIC 809). According to the Licensee, the adult grandson has been living with her for more than 3 years.

Type A deficiency and Civil Penalty was cited with licensee during today's visit.
An exit interview was conducted, and the report was reviewed with the facility representative, Delia Terrazas.
SUPERVISOR'S NAME: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:
DATE: 12/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/26/2023
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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Document Has Been Signed on 04/09/2024 03:43 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 39115 TRADE CENTER DR STE. 201
PALMDALE, CA 93551


FACILITY NAME: TERRAZAS FAMILY CHILD CARE
FACILITY NUMBER: 364843612

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/26/2023
Section Cited
CCR
102370(d)(2)

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(d) 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:
(2) Request a transfer of a criminal record clearance as specified in Section 102370(j) or.
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The licensee will ask her foster adult grandson to move out the facility until his fingerprints is clearen and associated with the facility.
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This requirement is not met as evidence by:
Based on observation and interviews, the
licensee did not ensure a criminal reocrd
clearance was associated for her grandson, which poses an immediated Health, Safety or
Personal Rights risk to persons 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: Claretta YatesTELEPHONE: (661) 202-3407
LICENSING EVALUATOR NAME: Carol HeathTELEPHONE: (661) 202-3709
LICENSING EVALUATOR SIGNATURE:
DATE: 12/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/26/2023
LIC809 (FAS) - (06/04)
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