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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215388
Report Date: 03/30/2022
Date Signed: 03/30/2022 04:31:44 PM


Document Has Been Signed on 03/30/2022 04:31 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:DELGADO FAMILY CHILD CAREFACILITY NUMBER:
426215388
ADMINISTRATOR:ROSA DELGADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 287-0577
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 10DATE:
03/30/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Rosa Delgado TIME COMPLETED:
04:40 PM
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On March 30, 2022 at 3:05 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management – COVID-19 inspection and met with, Rosa Delgado, Licensee. LPA informed the purpose for the inspection and completed a COVID-19 pre-screening questions prior to the commencement of the inspection. LPA and Licensee together toured the facility, inside and outside.

This inspection is a follow-up on COVID-19 outbreaks reported by facility staff to CCL between January 10, 2022 - January 13, 2022. CCL provided a Tele - Rapid Assistance Support Team (RAST) inspection on July 8, 2020, where LPA provided COVID-19 resources, current Childcare Industry Guidance, and a COVID-19 self-assessment guide to the facility.

LPA discussed facility’s written plan for when a staff member or child tests positive for COVID-19 and developing a written communication plan with parents/guardians to share information and guidelines in their preferred language. LPA discussed COVID-19, Face coverings, Essential Protective Equipment and Supplies, Physical Distancing, Ventilation, Isolation for Illness, Cleaning and Disinfection,

This Report Continues on LIC 809C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/30/2022
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: DELGADO FAMILY CHILD CARE
FACILITY NUMBER: 426215388
VISIT DATE: 03/30/2022
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Hand-washing, Food Service and Meal Times, How to Respond to Exposures or Outbreaks, and Resilience Tips during the Pandemic.

LPA reviewed that facility maintains a current Covid-19 Child Care Program Self-Assessment Guide/Mitigation plan. LPA also provided the following resources:
- Official Public Health and Child Care Guidance for COVID-19 – Updated 1/26/2022.

- COVID-19 Child Care Resources:
https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources

There were no deficiencies cited during today's inspection. A notice of site visit was given and must remain posted for 30 days.Failure to comply with posting requirements shall result in an immediate civil penalty of $100.


Exit interview conducted and report was reviewed with the licensee, Rosa Delgado.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022
LIC809 (FAS) - (06/04)
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