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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 304313965
Report Date: 01/03/2024
Date Signed: 01/03/2024 03:45:48 PM

Document Has Been Signed on 01/03/2024 03:45 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: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
01/03/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Maribel Soto, LicenseeTIME COMPLETED:
04:00 PM
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*** This report was translated into Spanish by LPA Valdez Santana ***

Licensing Program Analyst (LPA) Nguyen Nick Tran and LPA Dianna Valdez Santana conducted an unannounced complaint inspection to deliver an Amended Report to the report that was provided to the Licensee on 12/05/2023 case management visit. At 2pm, on 01/03/2024, LPA Tran met with Licensee Maribel Soto, who guided LPA on tour of the facility. Census was taken and observed were 4 children were supervised by Licensee and assistant.

A review of the Facility Personnel Report Summary on 01/03/2024 indicates all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions.

The report on 12/05/2023 was amended to correct the citation issued for deficiency observed during the visit. Citation for the observed deficiency on 12/05/23, is dismissed since the plan of correction for the same deficiency, was previously cited on 12/04/2023, is due on 12/11/2023.

Appeal Rights were discussed. The facility representative was provided with a copy of their 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. Notice of site visit was given and must remain posted for 30 days. An exit interview was conducted, and the amended report and this report was reviewed with Licensee Maribel Soto in Spanish.

(End of Report)
SUPERVISORS NAME: Judy Hanson
LICENSING EVALUATOR NAME: Nguyen K Tran
LICENSING EVALUATOR SIGNATURE: DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/03/2024
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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