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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304312411
Report Date: 08/02/2023
Date Signed: 08/02/2023 08:24:38 PM

Document Has Been Signed on 08/02/2023 08:24 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 CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME:JAUREGUI, MARTHA ALICIA & GUSTAVOFACILITY NUMBER:
304312411
ADMINISTRATOR:JAUREGUI, G & MARTHA AFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 699-1023
CITY:BUENA PARKSTATE: CAZIP CODE:
90620
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
08/02/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Licensee Marta JaureguiTIME COMPLETED:
08:30 PM
NARRATIVE
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On August 2, 2023 at approximately 1:00 PM, LPA A. Silva conducted an unannounced Case Management – Legal/Non-Compliance visit to inspect the facility for compliance.

Upon arrival the licensee had 13 children in care present at the daycare. Three were in the playground and the rest were napping. Among the napping children was infant C9. C9 was in a crib with loose articles. According to Section 102425(b) Infant Safe Sleep “(b) Cribs or play yards shall be free from all loose articles and objects.”

At around 1:00 PM, when the LPA arrived, C1, C2, and C3 were in the playground. LPA asked the three children if anyone had just left through the back alley. C1 stated that S2 took children out the back door. The LPA asked the names of the children who left with S2. C1, C2, and C3 provided the names of children C4, C5, C6, and C7. The licensee confirmed the names of C4, C5, C6, and C7. The licensee stated the four children (C4, 5, 6, 7) had been taken home by S2.

At 3:07 PM, the LPA interviewed P4, the parent of C4 and C5, over the phone. P4 stated C4 and C5 were in the day care. The LPA informed the licensee of the conversation with P4. The licensee stated C4, C5, C6, and C7 were at the park with S2, which means the facility had a total attendance of 17 children. S2 took C4, C5, C6, and C7 to the park at approximately 1:00 PM. S2 returned with C4, C5, C6, and C7 to the day care at approximately 3:40 PM, based on observations and interviews with children and the licensee.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 08/02/2023 08:24 PM - It Cannot Be Edited


Created By: Archibaldo Silva On 08/02/2023 at 06:52 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: JAUREGUI, MARTHA ALICIA & GUSTAVO
FACILITY NUMBER: 304312411

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/03/2023
Section Cited
CCR
102425(b)

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102425(b) Infant Safe Sleep Cribs or play yards shall be free from all loose articles and objects.
The licensee did not comply with the requirement above as evidenced by:
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The licensee stated she will remove the blanket from the crib and ask the parent to provide appropriate clothing for napping for C9.
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Based on observation, the licensee did not complay with the regulation above in 1 out of 1 infant at the time of inspection, which poses an immediate risk to the health and safety of clients. Licensee stated she understood only 12-month old and under are infants.
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Type A
08/03/2023
Section Cited
CCR102416.5(f)

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102416.5(f) Staffing Ratio and Capacity The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.”
The licensee did not comply with this requirement as evidenced by:
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The licensee stated she will not provide care for more than 14 children at a time. The stated licensee will not accept children that put the facility out of staffing ration and capacity.
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Based on interviews with clients, a parent, and licensee, the licensee did not comply with the requirement in 3 out of 3 children, which poses an immediate risk to the health and safety of clients. 15 to 17 clients were in attendance which is violation of license capacity and fire clearance.
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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:Patricia Magana
LICENSING EVALUATOR NAME:Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:
DATE: 08/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/02/2023


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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: JAUREGUI, MARTHA ALICIA & GUSTAVO
FACILITY NUMBER: 304312411
VISIT DATE: 08/02/2023
NARRATIVE
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Based on the licensee’s statements, the LPA determined the facility was in violation of Staffing Ratio and Capacity regulations. According to Title 22, Division 12, Chapter 1, Section 102416.5(d)(2) Staffing Ratio and Capacity, “(d) For a Large Family Child Care Home, the maximum number of children for whom care may be provided at any one time when there is an assistant provider in the home, including children under age 10 who reside at the licensee's home and the assistant provider's children under age 10, shall be either: … (2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 of the Health and Safety Code are met. Based on observation and statements made by the licensee, the 17 children in attendance breakdown is as follows: 9 school-age children, 6 preschool children, 1 toddler, and 1 infant.

Based on records and interviews with children and the licensee, the LPA determined the facility was in violation of fire clearance capacity and license capacity. The facility has fire clearance for a total of 14 children. The facility is licensed for a maximum capacity of 14 children. According to Title 22, Division 12, Chapter 1, Section 102416.5(f) Staffing Ratio and Capacity, “(f) The total licensed capacity for a Large Family Child Care Home shall not exceed fourteen children.” Between 15 and 17 children were in attendance at the day care on 8/2/23.

The facility was NOT in compliance. 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: 102425(b) Infant Safe Sleep, Section 102416.5(f) Staffing Ratio and Capacity.

LPA A. Silva informed licensee Martha Jauregui that this licensing report dated 8/2/2023 documents 2 “Type A” citation(s). Type A citation(s) must be posted for 30 consecutive days during the hours that children are in care as there is/are immediate risk(s) to the health, safety, or personal rights of children in care. LPA A. Silva further informed licensee Martha Jauregui that:
A copy of this licensing report must be provided to parents or guardians of all clients currently enrolled by the next business day or by the next day the children are in care.
A copy of this report must be provided to the parents or guardians of all newly enrolled clients for 12 months from the date of this report.
A signed Acknowledgement of Receipt of Licensing Report (LIC 9224) form, or another written equivalent statement, must be placed in the child's file for verification of receipt of the report.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
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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
ORANGE CO CHILD CARE, 750 THE CITY DRIVE, SUITE 250
ORANGE, CA 92868
FACILITY NAME: JAUREGUI, MARTHA ALICIA & GUSTAVO
FACILITY NUMBER: 304312411
VISIT DATE: 08/02/2023
NARRATIVE
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The LPA conducted an exit interview and reviewed the report with the licensee. 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.
SUPERVISORS NAME: Patricia Magana
LICENSING EVALUATOR NAME: Archibaldo Silva
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023
LIC809 (FAS) - (06/04)
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