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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312394
Report Date: 06/04/2024
Date Signed: 09/13/2024 03:52:33 PM

Document Has Been Signed on 09/13/2024 03:52 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: 9DATE:
06/04/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Licensee, AscencionTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Analyst (LPA) Sun conducted a case management visit on this date due to Licensee request to add the backyard covered patio to use for additional space. LPA met with Licensee, Ascbeth Esperanza Hernandez. LPA toured the facility inside and outside. Census was taken. Assistant was helping children to get settled for nap. There was 2 staff with a total of 9 children: 2 infants, 6 preschool, and 1 school age.

A review of the Facility Personnel Report Summary on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

Licensee stated that there are three individuals that she will remove from Personnel Report Summary.

LPA inspected facility. The measurement for this covered patio is 196 square feet. The patio will be used for additional space on rainy days, extreme hot days, special event, and activities for children. Inside the covered patio space there are dramatic play, manipulative, and art materials.

In the areas evaluated, no deficiencies were observed and cited today per CA Code of Regulations, Title 22, and Division 12.

The Notice of Site Visit was posted. Facility representative was informed that the Notice

of Site Visit must be posted for 30 consecutive days. Failure to post will result in civil penalties of $100.

Appeal Rights explained. All appeals must be in writing and received by the licensing office within 10 days.

END OF REPORT

SUPERVISORS NAME: Thuy Ho
LICENSING EVALUATOR NAME: Cynthia Sun
LICENSING EVALUATOR SIGNATURE: DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2024
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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