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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215957
Report Date: 03/24/2023
Date Signed: 03/24/2023 12:44:07 PM

Document Has Been Signed on 03/24/2023 12:44 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:VERA FCC EL TESORO DEL SABERFACILITY NUMBER:
426215957
ADMINISTRATOR:MARIA VERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 332-1464
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
03/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:23 AM
MET WITH:Maria VeraTIME COMPLETED:
12:44 PM
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On March 24, 2023 at 9:23 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced One (1) Year Required inspection. LPA asked pre- screening questions related to COVID- 19 and licensee’s responses indicate there are no COVID -19 exposure on site. LPA met with licensee, Maria Vera and explained the purpose of the inspection. There were 8 children and 2 staff present.

LPA in the company of Licensee toured the interior and exterior of the day care. Required licensing forms are posted in the wall by the entrance door. LPA observed age appropriate toys and equipment. LPA observed smoke and carbon monoxide detectors in the Family Child CAre Home (FCCH) The fire extinguisher was serviced on 2/23/2023.. Licensee was reminded that fire extinguisher should be serviced or to purchase a new one every year. Bathroom was observed to be clean and free of toxins. The home is clean and in order. Hazardous items and cleaning materials are kept inaccessible to day care children. The backyard is enclosed with wooden fence, surface is covered with artificial turf and concrete in one side. LPA observed age appropriate toys and play equipment. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the home.

LPA reviewed facility personnel report summary, Licensee's adult child who recently turned 18 years old has no Criminal Record Clearance (CRC) Licensee stated that she was under the impression that Adult # 1's CRC from Adult Senior care facility can be transferred to Child Care facility. LPA advised licensee to have Adult # 1 obtain new CRC to include the Child Abuse Clearance Index (CACI). Facility file was reviewed, Pediatric CPR and First Aid expires on 5/20/2024. Licensee and assistants renewed the Mandated Reported Training which will expire on 7/7/2023. Licensee and Assistant have required immunization record on file,

Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: VERA FCC EL TESORO DEL SABER
FACILITY NUMBER: 426215957
VISIT DATE: 03/24/2023
NARRATIVE
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 A sampling of children records were reviewed. It contains Emergency and Identification card. Licensee and assistants check and document napping infants every 15 minutes. Infant # 1 has no LIC 9227, Individual Safe Sleep Plan on file. Children's immunization are not updated on child's PM 286.

During today's inspection, Type A deficiency and Type B deficiencies were cited under Title 22 Division 12. Appeal Rights were given and discussed. A civil penalty of $ $500 was assessed.

LPA Reyes informed licensee Ms. Vera that this report dated 3/24/2023 documents one (1) Type A citation) which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care. Also, LPA Reyes informed the licensee, Ms. Vera to provide a copy of this licensing report dated 3/24/2023 that documents any Type A citation 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.


Continued on LIC 809 C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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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: VERA FCC EL TESORO DEL SABER
FACILITY NUMBER: 426215957
VISIT DATE: 03/24/2023
NARRATIVE
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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 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.
Licensee was reminded that all adults 18 year old 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.

Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty.

Exit interview conducted and report was reviewed with the licensee, Maria Vera.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2023
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Document Has Been Signed on 03/24/2023 12:44 PM - It Cannot Be Edited


Created By: Gigi Reyes On 03/24/2023 at 11:45 AM
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: VERA FCC EL TESORO DEL SABER
FACILITY NUMBER: 426215957

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102370(d)(1)
Criminal Record Clearance
(d) 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: (1) Obtain a California clearance or a criminal record exemption as required by the Department or

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review , the licensee did not comply with the section cited above in Adult # 1 who resides in the home did not obtain Criminal Record Clearance for Chidl Care Facility which poses an immediate health, safety or personal rights risk to persons in care.
Adult # 1 has a CRC for Adult Residential Facility where Adult # 1 but no CRC for Family Child Care Home.
POC Due Date: 03/27/2023
Plan of Correction
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Adult # 1 will obtain a criminal record clearance specific to FCCH on or before 3/27/2023
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:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2023


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Document Has Been Signed on 03/24/2023 12:44 PM - It Cannot Be Edited


Created By: Gigi Reyes On 03/24/2023 at 11:45 AM
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: VERA FCC EL TESORO DEL SABER
FACILITY NUMBER: 426215957

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2023

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 record review and interview the licensee did not comply with the section cited above, 1 out of 2 infants does not have a completed Individual Safe Sleep Plan on file (LIC 9227) on poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2023
Plan of Correction
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Licensee agreed submit a written plan of correction (POC) on how to ensure the LIC 9227 is completed and signed by the Infant's authorized representative and shall be on file. POC shall be submitted on or before 4/3/2023.
Type B
Section Cited
CCR
102418(g)(1)

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. (1) This requirement includes updating each child's PM 286 (6/95) when the child is due to receive required immunizations after enrollment in the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 6 out of 6 children, immunization record is not documented on child's PM286 as required which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/03/2023
Plan of Correction
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Licensee shall submit a POC on how to ensure tht children's immunization will be updated in child's PM 286 after enrollemnt in the FCCH. POC is due on 4/3/2023
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:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 03/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2023


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