<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312394
Report Date: 01/22/2025
Date Signed: 01/22/2025 04:22:09 PM

Document Has Been Signed on 01/22/2025 04:22 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
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:HERNANDEZ, ASCBETH ESPERANZAFACILITY NUMBER:
304312394
ADMINISTRATOR/
DIRECTOR:		HERNANDEZ, ASCBETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 415-9125
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
01/22/2025
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Licensee, Ascbeth Esperanza HernandezTIME VISIT/
INSPECTION COMPLETED:
04:30 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
On 1/22/25 Licensing Program Analyst (LPA) Cynthia Sun conducted an unannounced Case Management visit to ensure that the facility is staying within compliance of Title 22 regulations.

LPA walked into facility when licensee’s husband, Roberto Arevalo opened facility gate to bring in trash cans from street curb. Licensee came out of front house to playground and met with LPA. LPA took census, there was 2 infants and 5 preschool age children with 1 assistant (Argentina Velasquez) in the childcare area. Assistant was helping children get settled for nap. LPA observed 1 infant sleeping in crib/playpen covered with blanket and infants bottle inside crib/playpen. Assistant Jessica Delgado was in the kitchen washing dishes. 30 minutes later, Assistant Roberto Arevalo returned to facility with 3 school age children. The facility was operating within its licensed capacity and within compliance of staff-to-child ratios.

An on-site Facility Personnel Report Summary review showed that all facility residents, staff, or other individuals who require background checks have received criminal record and child abuse index clearances or exemptions.

LPA interviewed licensee (S1) about their daily schedule with the children in care and staff and ratio. S1 stated they currently have about 10-12 children attending daily. Children eat, nap, and play in the childcare areas. S1 stated they currently have 2 assistants, Staff #2 (S2) works weekends and two weekdays. S2 stated not aware if facility providing overnight care at this time, that last child leaves the childcare by 9:00pm-10:00 PM. S1 stated currently they are only providing transportation for older children when parents are in need, and they do not offer transportation to new enrolled families. S1 stated S1, S2 , and S3 are supervising the children in care.



Page 1 of 2
SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY CC RO, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HERNANDEZ, ASCBETH ESPERANZA
FACILITY NUMBER: 304312394
VISIT DATE: 01/22/2025
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
26
27
28
29
30
31
32
The facility was not in compliance and violations of the California Code of Regulations, Title 22, Division 12 were observed, discussed and cited at the time of the visit. The following violations of the California Code of Regulations, Title 22; Division 12, were observed and cited today: Infant Safe Sleep 102425(b) Cribs or play yards shall be free from all loose articles and objects. (see LIC 809D).

Licensee was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

The LPA conducted an exit interview and reviewed the report with the Licensee Ascbeth Esperanza Hernandez. The “Notice of Site Visit” was posted, and the licensee is aware that it shall remain posted for 30 days. The Appeal Rights were explained. The licensee received a copy of the Appeal Rights (LIC 9058 01/16), their signature on this form acknowledges receipt of these rights. All appeals must be in writing and received by the Regional Office within 15 business days. First-level appeals should be sent to the Regional Manager to the address listed above.

End of page 2

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE:

DATE: 01/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 01/22/2025 04:22 PM - It Cannot Be Edited


Created By: Cynthia Sun On 01/22/2025 at 03:43 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868

FACILITY NAME: HERNANDEZ, ASCBETH ESPERANZA
FACILITY NUMBER: 304312394

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/29/2025
Section Cited
CCR
102425(b)

1
2
3
4
5
6
7
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will place a Visual Resource to remind staff to only have infant in crib/playpen by today 1/22/25. Licensee will talk with facility assistant and go over Safe Sleep Best Practices by 1/29/25.
8
9
10
11
12
13
14
Based on observation, the licensee did not comply with the section cited above. LPA observed 1 infant sleeping in the crib and had loose blanket and baby bottle. This poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Thuy Ho
LICENSING EVALUATOR NAME:Cynthia Sun
LICENSING EVALUATOR SIGNATURE:
DATE: 01/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/22/2025


LIC809 (FAS) - (06/04)
Page: 3 of 3