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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426204203
Report Date: 06/14/2023
Date Signed: 06/15/2023 08:39:42 AM


Document Has Been Signed on 06/15/2023 08:39 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:ESPARZA FCC AKA MAYRA'S CHILD CAREFACILITY NUMBER:
426204203
ADMINISTRATOR:ESPARZA, ISABELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 964-3101
CITY:SANTA BARBARASTATE: CAZIP CODE:
93111
CAPACITY:14CENSUS: 10DATE:
06/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Isabel EsparzaTIME COMPLETED:
05:40 PM
NARRATIVE
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On 06/14/2023 at 12:00 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required Annual Inspection of the Family Child Care Home (FCCH). LPA met with Isabel Esparza, licensee of the FCCH. LPA discussed the purpose of the inspection and toured the interior and exterior of the home. LPA observed ten (10) children present during inspection being cared by licensee. LPA notes 3 out of the 10 children are infant age.

This is a two-story home that consists of seven (7) bedrooms, five (5) bathrooms, living room, formal living room, dining area, kitchen, garage, and outdoor yard. The main day care areas are living room, formal living room, dining room, kitchen, and bathroom and part of the outdoor yard are accessible to children in care. Meanwhile, two bedrooms, office room and one bathroom located on the first floor are inaccessible, along with the entire second floor that consists of four bedrooms and two bathrooms. Licensee reported that one bedroom is usually accessible to the children, but at the moment it is not accessible due to water damage that the home received during the recent storm. Licensee reported that the home has made changes since initially getting licensed and currently going through more construction again. LPA advised licensee to update FCCH application and facility sketch to reflect new construction and all off and on limits areas in the home.

The home is clean and orderly and has plenty of ventilation for children in care. At 12:10 PM, LPA observed a bottle of bleach, detergent, and other cleaning supplies on the kitchen counter accessible to children in care. tables and chairs. At 12:17 PM, LPA observed three playpens with loose items. Per licensee, there are no infants under the age of one enrolled at the FCCH. LPA and licensee discussed safe sleep regulations, LPA will send licensee resources regarding safe sleep. In the kitchen, LPA observed that sharps are stored in the counter facing the wall. Per licensee, medication is stored in licensee's bedroom that is located on the second floor. LPA observed cleaning compounds are stored in an elevated cabinet in the kitchen. LPA observed a fire place in the living that has a detached screen that is not secured. Licensee understands that fireplace needs to be secured and inaccessible to children in care. The bathroom used for childcare was observed to be clean and free of toxins. CONT 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2023
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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Document Has Been Signed on 06/15/2023 08:39 AM - 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: ESPARZA FCC AKA MAYRA'S CHILD CARE
FACILITY NUMBER: 426204203

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in laundry soap, fabric softener, bleach, soap was accessible throughout the kitchen which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/15/2023
Plan of Correction
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During today's visit, Licensee removed all toxins and stored in elevated cabinet in the kitchen that is inaccessible to children in care. Licensee will submit written statement detailing how licensee will ensure all toxins are inaccessible to children in care.
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(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: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in during inspection tour, licensee disclosed that are adults that live in the home and have not received fingerprint clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/15/2023
Plan of Correction
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Licensee agrees to ensure fingerprinted adults get fingerprinted. Licensee will make an appointment right away and will provide appointment date to LPA via email at Francisca.Velazquez@dss.ca.gov by 6/15/23. In addition, licensee will provide LIC 9163 once individuals have appointment.
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: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/15/2023 08:39 AM - 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: ESPARZA FCC AKA MAYRA'S CHILD CARE
FACILITY NUMBER: 426204203

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(d)
Staffing Ratio and Capacity
(d) 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:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that licensee was providing care and supervision to 10 children, 3 of which were infants without an assistant] which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/15/2023
Plan of Correction
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Licensee will submit a written statement detailing how she will ensure she will operate within her capacity and will submit via email at Francisca.Velazquez@dss.ca.gov by 6/15/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/15/2023 08:39 AM - 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: ESPARZA FCC AKA MAYRA'S CHILD CARE
FACILITY NUMBER: 426204203

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/14/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in that the FCCH is currently undergoing construction which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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Licensee agrees to update LIC999 and to reflect construction that is currently occurring. Licensee will also update LIC279 and LIC279b to reflect the current adults and minors that are living in the home.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that 8 out of the 10 children present during inspection were not documented in the facility roster which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/21/2023
Plan of Correction
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Licensee agrees to update LIC9040 (facility roster) and will submit via email to Francisca.Velazquez@dss.ca.gov by 6/21/23.
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: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:
DATE: 06/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/14/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6


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: ESPARZA FCC AKA MAYRA'S CHILD CARE
FACILITY NUMBER: 426204203
VISIT DATE: 06/14/2023
NARRATIVE
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During inspection tour, licensee disclosed that she did not have access to one bedroom. Licensee reported that her adult daughter, Alicia Esparza and her two minor children live in the bedroom. Per licensee, bedroom is locked and licensee does not have a key for that bedroom. LPA notes licensee's adult daughter is not fingerprint cleared or associated to this facility. Licensee reported her daughter's room is not accessible to children and therefore, she thought that she did not need to be fingerprint. Licensee also disclosed that a friend of her daughters has also stated in the home. Per licensee, Daisy Hernandez, friend of her adult daughter has stayed in the home for about one month this year. LPA notes this adult is also not fingerprinted and associated to the FCCH.

LPA and licensee toured outdoor playground. LPA observed that children only have access to part of the outdoor playground. LPA observed a fenced separating the outdoor playground. The side the children have access too is secured and has plenty of shade for the children in care. Filtered water is accessible to children by means of individual water cups. LPA observed that the side that is inaccessible to children in care has ongoing construction. LPA observed no bodies of water are on site.

Licensee stated that there are no weapons/ammunition in the home. Licensee stated she does not hold a foster family license. Record reviewed revealed, Licensee is current with First-Aid/CPR that expires on 4/9/24. Licensee's AB1207 Mandated reporter certificate expired 3/28/20. Licensee did not renew certificate as she was not aware this certificate needs to be renewed every two years. LPA reviewed facility roster and notes that two out of the ten children present were documented in the facility roster. LPA notes the last emergency drill was conducted and logged on 4/23/23. The fire extinguisher was observed and was serviced 06/01/2023. There is a functioning carbon monoxide detector and smoke alarm that were tested at 12:35 PM, in the home, that meets statutory requirements.



LPA reviewed children records and found three of the ten children did not child files. LPA notes that two of the three children are licensee's grandchildren and live in the home. The seven files available for review were complete and up to date.

Licensee is not providing Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: htttp://www.ada.gov/childqanda.htm
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: ESPARZA FCC AKA MAYRA'S CHILD CARE
FACILITY NUMBER: 426204203
VISIT DATE: 06/14/2023
NARRATIVE
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LPA reviewed with Licensee Safe Sleep Regulations. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided on line at www.ccld.ca.gov.

Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home and was advised to review Quarterly Updates and Provider Information Notices (PINs), Title 22 & Health & Safety Codes which can be accessed on-line athttps://www.cdss.ca.gov/inforesources/child-care-licensing

Today, deficiency cited under Title 22 Division 12 Appeal rights given, civil penalty was accessed. 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.

Exit interview and review of report was conducted with licensee, Isabel Esparza in Spanish due to Spanish being the licensee's primary language.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6