426215388-3-30-2022-17-CC-MJIZ-CCZVFS-20220330162426

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215388
Report Date: 03/30/2022
Date Signed: 03/30/2022 04:24:38 PM

Document Has Been Signed on 03/30/2022 04:24 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 CARE		FACILITY NUMBER:	426215388
ADMINISTRATOR:	ROSA DELGADO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 287-0577
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY:	14	CENSUS: 10	DATE:	03/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Rosa Delgado		TIME COMPLETED:	03:04 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	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 3/30/2022, at 11:35 AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Required Annual Inspection. LPA met with Rosa Delgado, Licensee, and Concepcion Roman, Assistant/Mother. At 11:47AM, LPA knocked and rang the door bells several times. LPA heard someone say in a loud voice in Spanish "I'm coming." from the left side of the street. LPA turned to the left and observed the licensee walking on the sidewalk with a minor day-care child (C10). As the licensee approached the driveway of the home the front door to the FCCH was opened by the assistant. Once inside the FCCH LPA observed in the day-care room four (4) infants and five (5) children in care with only the assistant present. The licensee stated that she had walked 3 blocks to the school, picked up C10 from school, and walked back to the FCCH. The licensee stated child#10 gets out of school at 11:40 am, and the licensee was absent from the FCCH for seven (7) minutes. The purpose of the visit was discussed with the Licensee. LPA and licensee together toured the home inside and outside. LPA observed 6 children and 4 infant in care at the time of the inspection. The main day care area is the day-care room, and bathroom. LPA observed in the children's bathroom to be free of toxins. 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 kitchen, dinning room, living room, four (4) bedrooms, and three (3) bathrooms secured with doorknob covers, safety gate and locks on the doors. The backyard is completely fenced. No bodies of water were observed. THIS REPORT CONTINUES ON LIC 809C & LIC 809D

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (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

NARRATIVE

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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 June 28, 2021. There is a functioning carbon monoxide detector and smoke alarm that were tested at 12:09 pm, in the home, that meets statutory requirements. Licensee and assistant are current with immunization required per SB 792. The last Safety drill was conducted and documented on March 30, 2022. Licensee is current with CPR and First Aid which expires March 26, 2024. Licensee completed the Mandated Reporter Training required per AB 1207, on March 23, 2021

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), Provision of Incidental Medical Services (PIN 22-02-CCP), 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 by LPA Jimenez LPA exited the FCCH at 1:55pm to attend a meeting and returned to the FCCH at to complete the inspection at 2:44 pm.

Today, deficiency cited under Title 22 Division 12, Appeal rights were given in Spanish.

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.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (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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Document Has Been Signed on 03/30/2022 04:24 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: DELGADO FAMILY CHILD CARE	FACILITY NUMBER: 426215388
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/30/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(b)(2)

Staffing Ratio and Capacity

(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following: (2) Six children, no more than three of whom may be infants; or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPAs observed At 11:47AM, LPA knocked and rang the door bells several times. LPA heard someone say in a loud voice in Spanish "I'm coming." from the left side of the street. LPA turned to the left and observed the licensee walking on the sidewalk with a minor day-care child. As the licensee approached the driveway of the home the front door to the FCCH was opened by the assistant. Once inside the FCCH LPA observed in the day-care room four (4) infants and five (5) children in care with only the assistant present, which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 04/01/2022
	Plan of Correction
1 2 3 4	Correct Immediately. Please submit a written plan of correction to Licensing for review by 4/1/2022, explaining how this violation will not be repeated.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 03/30/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2022

LIC809 (FAS) - (06/04)

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