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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213125
Report Date: 08/10/2023
Date Signed: 08/10/2023 03:29:49 PM

Document Has Been Signed on 08/10/2023 03:29 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CARRASCO FCC AKA JARDIN DE OLGA DAY CAREFACILITY NUMBER:
426213125
ADMINISTRATOR:OLGA CARRASCOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 346-8590
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
08/10/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Olga CarrascoTIME COMPLETED:
03:45 PM
NARRATIVE
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On 08/10/2023, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced One Year Required Inspection of the Family Child Care Home (FCCH). LPA met with Olga Carrasco and Jose Carrasco son and assistant of the FCCH and explained the purpose of the inspection. LPA, in the company of licensee toured the interior and exterior of the FCCH. LPA notes nine (9) children were present at arrival being cared by assistant, Maria Escalante, Jose Carrasco and licensee.

At 1:01 PM, LPA observed one (1) infant sleeping on a swing and one (1) infant sleeping in a playpen that had large pillow and blanket in the playpen.

This is a single-story home with three (3) bedrooms, two (2) bathrooms, living room, dining room, kitchen, garage has been turned into a bedroom with its own bathroom, outdoor shed that is used as a bedroom and outdoor yard. The daycare services occur in the living room, dining area, one (1) bathroom in the hallway of the home, one (1) bedroom and part of the outdoor yard. Meanwhile, the kitchen is inaccessible to children in care and barricaded with a baby gate. In addition, two (2) bedrooms and one (1) bathroom inside are inaccessible by means of a baby gate on the hallway of the home. The outdoor shed that is used as a bedroom is made inaccessible by means of a door safety knob. Lastly, the garage that was converted into a bedroom and bathroom is also inaccessible by means of a fence. LPA notes that the side of the outdoor yard are made inaccessible by means of a fence.

LPA observed the home to be clean and orderly. There is plenty of ventilation to afford the children comfort. LPA observed sharps are stored in an elevated cabinet in the kitchen. Cleaning compounds are stored in an elevated cabinet in the kitchen. Medication for the family is stored in the licensee’s bedroom that is inaccessible to children in care. LPA notes all areas are inaccessible to children in care by means of baby gate. The restroom that is used for childcare services is clean and free of toxins. In the FCCH, LPA observed toys, furniture, and equipment are in good conditions and are age appropriate for the children in care.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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 08/10/2023 03:29 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 08/10/2023 at 02:57 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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(b)
Infant Safe Sleep
(b) Cribs or play yards shall be free from all loose articles and objects.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that LPA observed one infant sleeping in a swing and one infant sleeping in a playpen that had a large pillow and blanket in the crib which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/11/2023
Plan of Correction
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Licensee agrees to write a statement detailing how Licensee will follow infant safe sleep regulations and will submit statement via email to Francisca.Velazquez@dss.ca.gov by 8/11/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: 08/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/10/2023 03:29 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 08/10/2023 at 02:57 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: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(c)
Infant Safe Sleep
An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and record review, the licensee did not comply with the section cited above in that licensee is not completing LIC9227 for all infants under the age of 1 year which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/17/2023
Plan of Correction
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Licensee agrees to have all famlies with children under the age of 1 year, complete LIC9227 and submit proof via email Francisca.Velazquez@dss.ca.gov by 8/17/2023.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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4
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: 08/10/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2023


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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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125
VISIT DATE: 08/10/2023
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Required forms are predominantly posted in the living room. LPA observed a combination smoke and carbon monoxide detector in the FCCH that were tested at 1:40 PM and was operable during this inspection. LPA observed the home has a regulation fire extinguisher that was serviced on 10/5/22. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services. Licensee informed LPA no guns or ammo are stored in the home.

LPA observed the outdoor yard to be completely fenced. LPA observed the exit doors to be secured. LPA observed a locked shed that is used as a bedroom. There is another shed that is locked and used as storage. LPA observed the sides of the outdoor yard are made inaccessible by means of permanent fencing separating the outdoor yard. There is a trailer in the inaccessible part of the yard that hold tools, liquids and equipment that belongs to licensee’s spouse. The outdoor yard provides plenty of shading for the children in care. Filtered drinking water is provided by means of individual cups that are labeled. Toys, furniture, and equipment observed in the outdoor yard are age appropriate and in good conditions. No bodies of water are observed.

LPA reviewed Licensee, assistants, and children's records. The children’s records were found to contain emergency contact information as well as immunization records. Licensee is documenting infant 15-minute sleep logs for all children under the age of two (2) years. Licensee reported that she is not collecting LIC9227 for all infants under the age of 1 year. Licensee currently has children under the age of 1 year. LPA collected a copy of the facility roster that contained the names of all children present during inspection. The last emergency drill was conducted and documented on 07/04/2023. LPA reviewed Licensee’s Pediatric First -aid certificate that is valid until 07/16/2024 and Licensee's Mandated Reporter training certification is valid until 12/16/2023. Assistant, Jose file was reviewed and current with Pediatric First -aid certificate that is valid until 07/16/2024 and Mandated Reporter training certification is valid until 07/13/2024.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
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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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CARRASCO FCC AKA JARDIN DE OLGA DAY CARE
FACILITY NUMBER: 426213125
VISIT DATE: 08/10/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an

for additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

During today’s inspection deficiencies are being cited.

Today, deficiency cited under Title 22 Division 12 Appeal rights given. Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report.

Exit interview and review of report was conducted in Spanish by LPA Velazquez with licensee, Olga Carrasco. Notice of site visit and appeal rights were provided to licensee.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
LIC809 (FAS) - (06/04)
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