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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 376620613
Report Date: 11/05/2024
Date Signed: 11/05/2024 02:26:48 PM

Document Has Been Signed on 11/05/2024 02:26 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
SAN DIEGO CC RO, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108
FACILITY NAME:MARTINEZ, ESPERANZA FAMILY CHILD CAREFACILITY NUMBER:
376620613
ADMINISTRATOR/
DIRECTOR:		ESPERANZA MARTINEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(619) 587-5010
CITY:CHULA VISTASTATE: CAZIP CODE:
91911
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
11/05/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:40 PM
MET WITH:Esperanza Martinez, LicenseeTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On 11/05/2024 at 1:40 pm, Licensing Program Analysts (LPA) Michelle Hood and Danielle Anderson conducted an unannounced case management inspection. The LPAs met with the licensee Esperanza Martinez. LPAs observed four children in care with two helpers.

During an initial 10-day inspection on 11/05/2024, it was determined based on a record review the two helpers at the facility are not fingerprint cleared and associated to the facility.

LPAs Hood and Anderson informed licensee Esperanza Martinez that this report dated 11/05/2024 documents two (2) Type A citations which shall be posted for 30 consecutive days as there is/are immediate risks to the health, safety, or personal rights of children in care.

Also, LPAs Hood and Anderson informed the licensee Esperanza Martinez to provide a copy of this licensing report dated 11/05/2024, that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

An exit interview was conducted with licensee Esperanza Martinez. The licensee was provided appeal rights (LIC9058) and their signature on this form acknowledges receipt of these rights. A notice of site visit was provided. LPAs observed that LIC 9213 was posted. See LIC 809D for the deficiencies.

The helper Aylhea Zazueta translated in Spanish.

SUPERVISORS NAME: Cynthia Biszant
LICENSING EVALUATOR NAME: Michelle Hood
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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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Document Has Been Signed on 11/05/2024 02:26 PM - It Cannot Be Edited


Created By: Michelle Hood On 11/05/2024 at 01:41 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
, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MARTINEZ, ESPERANZA FAMILY CHILD CARE
FACILITY NUMBER: 376620613

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2024
Section Cited
CCR
102370(d)(l)

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102370(d)(l) Criminal Record Clearance All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not as evidenced by:
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The Licensee stated she will ensure all individuals will be cleared and associated to the facility prior to working at the facility. The licensee will provide LPA Hood with a copy of the completed Livescan form no later than 11/06/2024.
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Based on record review, two adult workers did not obtain the required criminal record clearance or exemption prior to being present at the facility or transporting child. This is an immediate health & safety risk to 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:Cynthia Biszant
LICENSING EVALUATOR NAME:Michelle Hood
LICENSING EVALUATOR SIGNATURE:
DATE: 11/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/05/2024


LIC809 (FAS) - (06/04)
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