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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313965
Report Date: 12/04/2023
Date Signed: 12/04/2023 02:45:47 PM


Document Has Been Signed on 12/04/2023 02:45 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:SOTO DELGADILLO, MARIBELFACILITY NUMBER:
304313965
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
12/04/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Maribel Soto, LicenseeTIME COMPLETED:
03:00 PM
NARRATIVE
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*** This report was translated into Spanish for Licensee by LPM Magana ***

Licensing Program Analyst (LPA) Tran conducted a case management to address deficiencies observed during an unannounced visit on 12/04/2023. Observed at the time of the visit was a total of 7 children including 3 infants and 4 preschool children. LPA informed the Licensee of the purpose of the visit.

A review of the Facility Personnel Report Summary on 12/04/2023 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

At 9am, LPAs observed Licensee caring for 7 children without an assistant. Licensee was operating out of capacity for a small family child care home. When asked about the children roster, Licensee stated she did not have a roster for the children in care. Licensee also did not have files for 4 children (Child #1 (C1), Child #2 (C2), Child #3 (C3) and Child #(4)) out of 7 children in care, Licensee stated that the 4 children, C1, C2, C3 and C4 are not attending the day care regularly so Licensee does not know their last name or date of birth. Licensee identified C1, C5 and C6 are infants and did not know for sure about C4.

At 9:15am, LPA asked Licensee about the sleeping equipment for the infants in care. Licensee stated Licensee only has one play yard for 1 infant, The rest of children sleep on the bed in the bedroom and 1 cot in the living room. At 9:17am, LPAs observed Licensee utilized 1 baby saucer and 4 baby rockers in the childcare area. The saucer and 2 rockers were occupied by 3 infants. LPA addressed concerns about the items that were not permitted to be used in the childcare. Licensee immediately removed the children from the baby saucer and rockers at 9:30am.

(Continue next page)
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
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 7


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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965
VISIT DATE: 12/04/2023
NARRATIVE
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(Page 2 of Report)

At 10:47am, LPA Tran and Navar observed C3 crying under a table in the play yard. LPAs observed and obtained photograph of dog feces right next to C3. LPAs addressed the concern with Licensee, Licensee immediately cleaned up the dog feces.

At 11am, Parent #2 (P2) arrived and picked up C2 and C3, P2 provided information regarding C2 and C3 when interviewed. At 11:05 am, Parent #1 (P1) arrived and picked up C1, P1 provided information about C1. Licensee was back in ratio.

At 12:30pm, Parent #3 (P3) came to pick up C4 and provided information for C4 when LPA interviewed.

At 12:35pm, Parent #4 (P4) came to drop off child #8 (C8), P4 provided information for C8 as LPA interviewed. Licensee did not a file for C8 and stated that C8 was new to the day care.

During record review of Child #5 and Child #6, LPA did not see the Sleep log to document the 15-minute checks while the infants are napping, Licensee stated she did not keep document of the Sleep log.

Based on LPAs' observations, record reviews and interviews, the following deficiencies were observed in accordance to California Code and Regulations, Tittle 22, Division 12, Section 102416.5 (b)(2) Staffing Ratio and Capacity, 102417 (b), 102417 (d)(1), 102417 (g)(7), 102417 (g)(8) Operation of a Family Child Care Home, 102425 (a), 102425 (c) and 102425 (j)(2) Infant Safe Sleep, are being cited on the attached 809D.

Due to the Type A violations cited today, the licensee shall post, and provide copies, of the report to parents/guardians of the children in care at the facility by the next business day, and shall provide to the parents/guardians of children newly enrolled at the facility during the next 12 months. The licensee is to keep Acknowledgement Receipt (LIC 9224) signed by parents in each child’s file. In addition, the licensee shall immediately post upon receipt the Proof of Correction for 30 consecutive days.
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 12/04/2023 02:45 PM - It Cannot Be Edited

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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/04/2023
Section Cited
CCR
102416.5(b)(2)

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102416.5 Staffing Ratio and Capacity (b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time...shall be one of the following: ...(2) Six children, no more than three of whom may be infants...
This requirement is not met evidenced by:
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Licensee immediately called parents to come and pick up the children so she can operate within ratio and capacity.
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Based on LPAs observation and interview, Licensee was observed caring for 7 children (Licensee confirmed 3 out of 7 children were infants), this posed an immediate health safety and personal rights risk to children in care.
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Type A
12/04/2023
Section Cited
CCR102417(b)

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102417 Operation of a Family Child Care Home (b) The home shall be kept clean and orderly.
This requirement is not met evidenced by:
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Licensee immediately cleaned the dog's feces when LPAs addressed the concern.
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Based on observation, at 9:47am, LPAs observed Child #3 who were crying under a table in the playground and there were dog feces right next to the child, this posed an immediate health, safety and personal rights risk to the children in care.
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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: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 3 of 7


Document Has Been Signed on 12/04/2023 02:45 PM - It Cannot Be Edited

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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2023
Section Cited
CCR
102417(d)(1)

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102417 Operation of a Family Child Care Home (d) The home shall provide...play equipment and materials. (1) ...equipment that have been banned, shall not be used for children in care...
This requirement is not met evidenced by:
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Licensee immediately removed the baby saucer and 4 baby rockers from the child care area when LPAs addressed concerns about the items are not permitted to be used in a child care home.
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Based on observation, at 9:17am, LPAs observed Licensee utilized 1 babysaucer and 4 baby rockers in the childcare area. The saucer and 2 rockers were occupied by 3 children, this posed a potential health, safety and personal rights risk for the children in care.
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Type B
12/11/2023
Section Cited
CCR102417(g)(7)

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102417 Operation of a Family Child Care Home (g) ...Safety precautions shall include...: (7) An emergency information card shall be maintained for each child...
This requirement is not met evidenced by:
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Licensee states she will obtain emergency card and necessary paperwork for the children in care. Licensee states she will submit proof of completed and updated files for C1, C2, C3, C4 and C8, to LPA by due date.
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Based on record review, Licensee did not have emergency card for Child #1, Child #2, Child #3, Child #4 and Child #8, this posed a potential health, safety and personal rights risk for the children in care.
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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: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 4 of 7


Document Has Been Signed on 12/04/2023 02:45 PM - It Cannot Be Edited

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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/11/2023
Section Cited
CCR
102425(a)

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102425 Infant Safe Sleep (a) There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard. This requirement is not met evidenced by:
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Licensee states she will purchase extra playyards for the infants and will provide proof of purchases to LPA by due date.
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Based on observation and interview, Licensee confirmed that she has only 1 play yard in the famlily daycare home while she has at least 3 infants in care, this posed a potential health, safety and personal rights risk for the children in care.
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Type B
12/11/2023
Section Cited
CCR102417(g)(8)

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102417 Operation of a Family Child Care Home (g) ...Safety precautions shall include...: (8) Each family child care home shall have a current roster of children
This requirement is not met evidenced by:
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Licensee states she will submit an updated roster for the children in care, to LPA by due date.
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Based on interview and record review, Licensee stated she did not have the roster for the children in care, this posed a potential health, safety and personal rights risk for the children in care.
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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: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 5 of 7


Document Has Been Signed on 12/04/2023 02:45 PM - It Cannot Be Edited

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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/04/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/11/2023
Section Cited
CCR
102425(j)(2)

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102425 Infant Safe Sleep (j) The provider shall supervise infants while they are sleeping ...(2) The provider shall check and document

This requirement is not met evidenced by:
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Licensee states she will submit the Sleep log for the infants in care, to LPA by due date.
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Based on interview and record review, LPA did not see the Sleep log to document the 15-minute checks while the infants are napping, Licensee stated she did not keep document of the Sleep log, this is an immediate risk to the health, safety and personal rights risk to the children in care.
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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: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:
DATE: 12/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 7 of 7


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: SOTO DELGADILLO, MARIBEL
FACILITY NUMBER: 304313965
VISIT DATE: 12/04/2023
NARRATIVE
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(Page 3 of Report)

Appeal Rights were explained. The Licensee was provided a copy of appeal rights (LIC 9058) and 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. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Maribel Soto.

(End of Report)
SUPERVISOR'S NAME: Judy HansonTELEPHONE: (714) 713-2822
LICENSING EVALUATOR NAME: Nguyen K TranTELEPHONE: (714) 658-6048
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7