426215388-8-31-2023-17-CC-FVEZ-CV8PYU-20230831114431

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215388
Report Date: 08/31/2023
Date Signed: 08/31/2023 11:44:40 AM

Document Has Been Signed on 08/31/2023 11:44 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:	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: 7	DATE:	08/31/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Rosa Delgado		TIME COMPLETED:	11:50 AM

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 8/31/23, Licensing Program Analyst (LPA) Francisca Velazquez conducted a unannounced One Year Required inspection of the Family Child Care Home (FCCH). LPA met with Rosa Delgado, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. The home has a daycare room that has its own small kitchen and bathroom that are used for daycare services. Meanwhile the rest of the home is inaccessible to children in care. LPA notes that children pass through the kitchen, dining room and living room to get to the outdoor yard. LPA observed the daycare room to have a safety latch. At the time of this inspection, there was 7 children present with licensee and assistant providing care and supervision. The home was orderly and void of hazardous items. The bathroom used by the children was observed to be clean and free of toxins. Cleaning compounds were observed under the sink of the main kitchen that is locked, in the laundry room that is inaccessible to children and in the bathrooms that are not used for childcare services. Sharps are observed in elevated cabinet in both kitchens. Medication is secured in an elevated cabinet in the hallway of the home. Toys, furniture and equipment observed in the FCCH are age appropriate. LPA observed a fire extinguisher (2A10BC) in the home which was purchased on 06/25/23. LPA reminded Licensee of the responsibility to service or purchase a regulation fire extinguisher annually. The home has combination smoke/carbon monoxide detectors. A combination smoke/carbon monoxide detector was tested at 10:30 AM and found to be operable. The backyard is enclosed by wooden fencing. Toys and play equipment observed in backyard are age appropriate and in satisfactory condition. The FCCH's backyard footing is made up of concrete. LPA notes part of the yard is made inaccessible by means of a gate. Licensee reported she will ensure the gate is always secured. Filtered water is accessible to children in care by means of individual water cups. LPA observed no bodies of water on site. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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 08/31/2023 11:44 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: DELGADO FAMILY CHILD CARE	FACILITY NUMBER: 426215388
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/31/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)(c)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above in that licensee is not documenting 15 minute checks for all infants under the age of 2 years which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/07/2023
	Plan of Correction
1 2 3 4	Licensee and assistant will start to document 15 minute checks for all infants under the age of 2 years and will email proof by 09/07/23 to Francisca.Velazquez@dss.ca.gov

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: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

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: 08/31/2023

NARRATIVE

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LPA reviewed a sampling of children's records. Records reviewed were complete and contained required licensing documentation and forms. LPA reviewed infant safe sleep documentation for all infants under the age of two years. Licensee informed LPA that she is not documenting 15 minute checks for all infants under the age of two years when they sleep because she understood it was only for children under the age of 1 year. Licensee will start documenting 15 minute sleep checks for all infants under the age of 2 years. The Licensee's records are also current and complete with Pediatric CPR and First Aid certifications expiring on 3/26/24 (EMSA approved). Licensee Mandated Reporting training is currently, with an expiration date of 6/21/25. Licensee informed LPA no firearms or ammunition is in the home.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 8/31/23.

During today’s inspection deficiency is being cited. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Rosa Delgado in Spanish due to Spanish being the primary language of the licensee.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023

LIC809 (FAS) - (06/04)

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