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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213125
Report Date: 07/12/2022
Date Signed: 07/12/2022 03:44:42 PM


Document Has Been Signed on 07/12/2022 03:44 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:CARRASCO FCC AKA JARDIN DE OLGA DAY CAREFACILITY NUMBER:
426213125
ADMINISTRATOR:OLGA CARRASCOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 346-8590
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 14DATE:
07/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Olga Carrasco TIME COMPLETED:
04:15 PM
NARRATIVE
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Due to COVID-19 pandemic, LPA asked the pre-screening questions prior to inspection. Licensee's responses indicate there was no COVID-19 exposure on site.

On 7/12/2022, at 9:10 AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Required Annual Inspection of the home. LPA met with Licensee Olga Carrasco, Licensee, Jose Carrasco, Assistant(A1) and Maria Socorro Hernandez-Medel, Assistant (A2). The purpose of the visit was discussed with the Licensee and together we toured the inside and outside of the home. LPA observed 11 children and 3 infant in care at the time of the inspection.

At 9:20 AM, upon arrival LPA observed assistant (A2) in the kitchen washing dishes, a few minutes later (at approximately 9:40 AM) the assistant walked outside to the location where the day-care children were playing to care for two (2) infants in care.

LPA interviewed licensee and Ms. Hernandez-Medel, who stated during the interviews it was confirmed that Maria Socorro Hernandez -Medel, assistant has been working in the day-care since July 11, 2022. Ms. Hernandez-Medel does not have a criminal record clearance to assist in the home.

LPA provided licensee with documentation regarding Criminal Record Clearance and Criminal Record statement (LIC 508). The following CCR, Title 22, Division 12 regulation was cited: 102370 (d)(1) Criminal Record Clearance.

At 12:07 PM, LPA observed an infant asleep in the bassinet at the time of the inspection. LPA observed three (3) infants in care with one(1) packNplay and a one (1) bassinet.

The main day care areas are living room, dining room, kitchen, bedroom and hallway bathroom. LPA observed in the kitchen a drawer unsecured with knives accessible to children in care. LPA observed the day care area to be clean and orderly. LPA observed age appropriate books, toy, games, tables and chairs. LPA observed the off-limits areas which include the 3 bedrooms and 2 bathrooms secured with a safety gate in the hallway and doorknob covers on the doors.

THIS REPORT CONTINUES ON LIC 809C & LIC 809D
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022
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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125
VISIT DATE: 07/12/2022
NARRATIVE
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The backyard is completely fenced. LPA observed age appropriate toys, bikes, play structure and playhouses LPA observed a chicken in the children's playhouse. LPA observed a day-care child (C2) run to the playhouse and tell (C3) not to go into the playhouse. Licensee advised LPA the children are not allowed in the playhouse because the chicken may pic the children. LPA also observed a small outdoor dog in the children's play area accessible to children in care. No bodies of water were observed.

Licensee stated that there are no weapons/ammunition in the home. Licensee stated she does not hold a foster family license. LPA reviewed the facility roster. The fire extinguisher was observed and was serviced October 5, 2021. There is a functioning carbon monoxide detector and smoke alarm that were tested at 11:53 am, in the home, that meets statutory requirements. Licensee and assistant (A1) are current with immunization required per SB 792. The last Safety drill the last fire drill conducted and documented was on June 15, 2022. Licensee is current with CPR and First Aid which expires September 4, 2022. Licensee Mandated Reporter Training required per AB 1207, expires on December 16, 2023. Assistant (A1) has not completed the Mandated Reporter Training required per AB 1207.

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

LPA reviewed with Licensee the Safe Sleep Regulation (PIN 20-24-CCP-SP) The Effects of Lead, and What is Carbon Monoxide.. 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’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.


Type A deficiencies and a $500 civil penalty were cited today: Posting Requirement. THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/12/2022 03:44 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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2022

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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LPA observed in the kitchen a drawer unsecured with knives accessible to children in care, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/13/2022
Plan of Correction
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Licensee will email photos of the knives inaccessible to children in care by July 13, 2022.
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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LPA interviewed licensee and Ms. Hernandez-Medel, who stated during the interviews it was confirmed that Maria Socorro Hernandez -Medel, assistant has been working in the day-care since July 11, 2022. Ms. Hernandez-Medel does not have a criminal record clearance to assist in the home, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/13/2022
Plan of Correction
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Ms. Maria Socorro Hernandez-Medel must get a criminal record clearance and submit all documents to the Community Care Licensing (CCL) by July 13, 2022. A $200 civil penalty was assessed

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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6


Document Has Been Signed on 07/12/2022 03:44 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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(a)
Infant Safe Sleep
(a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 12:07 PM, LPA observed an infant asleep in the bassinet at the time of the inspection. LPA observed three (3) infants in care with one(1) pacNplay and a one (1) bassinet, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/19/2022
Plan of Correction
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Licensee will submit verification 3 pacNplay's for all 3 full time infants in care by 7/19/2022. Via email: Martina.Jimenez@dss.ca.gov
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Assistant (A1) has not completed the Mandated Reporter Training required per AB 1207, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/19/2022
Plan of Correction
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Licensee verification of assistant (A1) mandated reporter training certificate to CCLD by 7/19/2022, via email: Martina.Jimenez@dss.ca.gov

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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6


Document Has Been Signed on 07/12/2022 03:44 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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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LPAs observation, interview, and record review revealed that Maria Socorro Hernandez-Medel, did not have verification of immunization's, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/19/2022
Plan of Correction
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Licensee will submit verification of Maria Socorro Hernandez-Medel's immunization to CCLD by 7/19/2022, via email: Martina.Jimenez@ds.ca.gov
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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LPAs observation, interview, and record review revealed that Maria Socorro Hernandez-Medel, did not have verification of immunization's, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/19/2022
Plan of Correction
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Licensee will submit verification of Maria Socorro Hernandez-Medel's immunization to CCLD by 7/19/2022, via email: Martina.Jimenez@ds.ca.gov

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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6


Document Has Been Signed on 07/12/2022 03:44 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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102423(a)(2)
Personal Rights
(a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
Deficient Practice Statement
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 LPA observed a chicken in the children's playhouse. LPA observed a day-care child (C2) run to the playhouse and tell (C3) not to go into the playhouse. Licensee advised LPA the children are not allowed in the playhouse because the chicken may pic the children, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/19/2022
Plan of Correction
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Licensee secured the chicken during the inspection in a portable cage. Licensee stated will be making a permanent cage for the chicken by 7/19/2022. Licensee will email photos to CCLD of completed cage by 7/19/2022
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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 07/12/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/12/2022
LIC809 (FAS) - (06/04)
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