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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215954
Report Date: 03/13/2024
Date Signed: 03/14/2024 09:02:39 AM

Document Has Been Signed on 03/14/2024 09:02 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:RODARTE FCC AKA EXPRESS DAY CAREFACILITY NUMBER:
406215954
ADMINISTRATOR:ANA L RODARTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 704-5057
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
03/13/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Ana L. Rodarte TIME COMPLETED:
04:33 PM
NARRATIVE
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On March 13, 2024, 1:05 PM, Licensing Program Analysts (LPAs) Francisca Velazquez and Joaquin Mendez conducted an unannounced Case Management- Incident inspection. LPAs met with Ana Rodarte, Licensee of the Family Child Care Home (FCCH) and advised her the purpose of the inspection. LPAs and Licensee toured the FCCH inside and out. LPAs note there were nine (9) children in care at the time of the inspection with Licensee and Assistant.

On March 8, 2024 Community Care Licensing (CCL), Centralized Complaint and Information Bureau (CCIB) received an anonymous online complaint regarding an incident that occurred at the FCCH on March 5, 2024.

During today's inspection, Licensee disclosed details of the incident which lead law enforcement to conduct a visit to the FCCH. Licensee disclosed the incident occurred after day-care hours and confirmed no children were present during the incident. Per licensee, since the incident occurred outside of day-care hours, Licensee did not think that this incident needed to be reported to CCL. Additionally, Licensee reported that she did not have an incident number or any of the names of the officers who arrived to the FCCH. Therefore, Licensee did not self report this incident to CCL.

During today's inspection, Type B deficiency (HSC 1597.467(c) is being cited for not reporting this incident.

An exit interview was conducted with Licensee, Ana Rodarte. Appeal Rights were provided. Notice of site visit and was provided to the Licensee.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/13/2024
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 03/14/2024 09:02 AM - It Cannot Be Edited


Created By: Francisca Velazquez On 03/13/2024 at 03:16 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
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RODARTE FCC AKA EXPRESS DAY CARE
FACILITY NUMBER: 406215954

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/20/2024
Section Cited
HSC
1597.467(B)(1)(c)

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A report shall be made to the department...following the occurrence during the operation of a FCCH...(c) any...incident...that threatens the physical or emotional health or safety of any child. This requirement was not met as evidenced by:
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Licensee agrees to report any and all unusal incidents and agress to submit a written statment detailing how she will ensure this requirement is met. Written statement is due by 3/20/24 via email Francisca.Velazquez@dss.ca.gov
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Based on Licensee interview it was disclosed that an incident occured on 3/5/24 that lead to law enforcement visiting the FCCH. Additionally, an adult who lives in the home was arrested. This is a potential risk to the health, and safety and personal rights of 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:Maria Mueller
LICENSING EVALUATOR NAME:Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/13/2024


LIC809 (FAS) - (06/04)
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