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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 444412917
Report Date: 02/15/2023
Date Signed: 02/15/2023 10:24:52 AM

Document Has Been Signed on 02/15/2023 10:24 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, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:ROCHA, ESPERANZAFACILITY NUMBER:
444412917
ADMINISTRATOR:ROCHA, ESPERANZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 728-2758
CITY:WATSONVILLESTATE: CAZIP CODE:
95076
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
02/15/2023
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Esperanza RochaTIME COMPLETED:
10:30 AM
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On 02/15/2023 at 9:40 AM Licensing Program Manager (LPM), Mary Segura, and Licensing Program Analyst (LPA), Elizabeth Berumen, met with Licensee, Esperanza Rocha for an informal office meeting. The purpose of the meeting is to discuss the type A violation cited on January 20, 2023. A 4 year old day-care child wandered away from the family child care home and was found by a passerby.

Absence of supervision; child wandered outside of the facility without licensee's knowledge is a zero tolerance issue.
LPM explained to licensee the seriousness of the deficiency and disciplinary measures that may be taken if the licensee has repeat violations concerning care and supervision or other immediate risk to health and safety.

LPA will increase visits in the next 12 months to ensure compliance with all regulatory requirements.

LPA discussed the requirements of AB633 to licensee and provided them the AB633 fact sheet and a copy of Acknowledgement of Receipt of Licensing Reports (LIC 9224) and licensee understands the requirements. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

No deficiencies were cited during today's meeting. Exit interview conducted and report was reviewed with Licensee, Esperanza Rocha.
SUPERVISORS NAME: Mary Segura
LICENSING EVALUATOR NAME: Elizabeth Berumen
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2023
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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