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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312394
Report Date: 12/05/2023
Date Signed: 12/05/2023 07:18:16 PM

Document Has Been Signed on 12/05/2023 07:18 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, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:HERNANDEZ, ASCBETH ESPERANZAFACILITY NUMBER:
304312394
ADMINISTRATOR:HERNANDEZ, ASCBETHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 415-9125
CITY:ANAHEIMSTATE: CAZIP CODE:
92805
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
12/05/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
12:05 PM
MET WITH:Ascbeth Esperanza Hernandez - LicenseeTIME COMPLETED:
02:00 PM
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On 12/05/23 Licensing Program Analyst (LPA) Odom conducted an unannounced Case Management visit to ensure that the facility is staying within compliance of Title 22 regulations.

LPA met with Licensee Ascbeth Esperanza Hernandez. LPA took census, there was 1 infant, and 5 preschool age children with 1 assistant (Argentina Velasquez) in the childcare area. Licensee was in the kitchen preparing the meals and Staff #2 was supervising the children during outdoor play. Licensee’s spouse was also in the facility in the backyard. LPA observed licensee’s spouse return from running errands and enter the facility through the front door in an off-limit area. 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 9-10 children attending daily. Children eat, nap, and play in the childcare areas. S1 stated they currently have 2 assistants, Staff #2 (S2) works Monday to Friday and S3 works on the weekend Saturday and Sunday. S1 stated they are no longer providing overnight care at this time. S1 stated Staff #4(S4) is currently assisting with transportation, 2 children daily and 5 other children on occasions. S1 stated S1, S2 and S3 are the staff that’s always supervising the children in care.

In the areas that were evaluated, no deficiencies were observed of the California Code of Regulations, Title 22, Division 12 at the time of the visit.

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 Child Care Center. 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.

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SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: HERNANDEZ, ASCBETH ESPERANZA
FACILITY NUMBER: 304312394
VISIT DATE: 12/05/2023
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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.
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Carmen Odom
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023
LIC809 (FAS) - (06/04)
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