<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215020
Report Date: 05/15/2024
Date Signed: 05/15/2024 01:52:12 PM


Document Has Been Signed on 05/15/2024 01:52 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:LEMOINE-BECERRA FAMILY CHILD CAREFACILITY NUMBER:
406215020
ADMINISTRATOR:JAMIE LEMOINE-BECERRAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 458-5433
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:14CENSUS: 15DATE:
05/15/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jamie Lemoine-BecerraTIME COMPLETED:
12:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 5/15/2024 at 10:00 AM, Licensing Program Analysts (LPAs) Gigi Reyes and Elizabeth George conducted an unannounced Case Management inspection. LPAs met with 2 Staff Assistants, Haylee Ferrell and Madison Mueller and explained the purpose of the inspection. Licensee was not present at the time of the inspection who arrived at the Family Child Care Home, 20 minutes later.

During the inspection, LPAs observed 15 children present at the FCCH under the care of 2 Assistants. The children's ages ranged from 3 to 5 years old. To correct the over capacity, Licensee contacted the authorized representative of Child # 1 and Child # 2 to pick them up, leaving 13 children in the day care. However, the FCCH is still not in compliance because there are no school age-children among the remaining 13. The review of the FCCH's attendance for the week of May 13 - 17, 2024, It was observed that FCCH was also over capacity on May 14, 2024, there were 16 children present whose ages ranged from 3 to 5 years old.

During today's inspections, deficiencies were cited under Title 22 Division 12 and Health and Safety Code.

Continued on LIC 809C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


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: LEMOINE-BECERRA FAMILY CHILD CARE
FACILITY NUMBER: 406215020
VISIT DATE: 05/15/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA Reyes informed Licensee, Jamie Lemoine -Becerra that this report dated 5/15/2024 documents two (2) Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care. Also, LPA Reyes informed the Licensee to provide a copy of this licensing report dated 5/15/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report.

Exit interview conducted and report was reviewed with Licensee, Jamie Lemoine-Becerra

A notice of site visit was given to licensee , and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.










Continued on LIC 809C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 05/15/2024 01:52 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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117


FACILITY NAME: LEMOINE-BECERRA FAMILY CHILD CARE
FACILITY NUMBER: 406215020

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/16/2024
Section Cited
CCR
102416.5(f)

1
2
3
4
5
6
7
The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee contacted the authorized reperesentative of C1and C2 to pick up the children.
Licensee agreed to disenroll families to be in License will submit a written POC to CCL no later than 5/16/2024.
8
9
10
11
12
13
14
During the inspection on 5/15/2024, LPAs observed 15 children in care. The review of 5/14/2024 attendance record revealed that FCCH had total of 16 children present 5/14/2024 This poses an immediate risk to children in care.
8
9
10
11
12
13
14
Type A
05/16/2024
Section Cited
HSC1597.465(a)

1
2
3
4
5
6
7
 A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met:
(a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee agreed to disenroll families. Written POC shall be submitted no later than 5/16/2024. gigi.reyes@dss.ca.gov
8
9
10
11
12
13
14
During today's inpection and review of FCCH attendance record, LPAs observed 15 children present (reduced to 13) whose ages ranged from 3 to 5 years and there were no school age children among these children. This poses an immedite risk to health and safety of children in care.
8
9
10
11
12
13
14
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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/15/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3