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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215957
Report Date: 04/14/2023
Date Signed: 04/14/2023 04:05:15 PM

Document Has Been Signed on 04/14/2023 04:05 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: 6DATE:
04/14/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
02:36 PM
MET WITH:Maria VeraTIME COMPLETED:
04:15 PM
NARRATIVE
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On April 14, 2023 at 2:36 PM, Licensing Program Analyst (LP) Gigi Reyes conducted an unannounced Case Management inspection at the above Family Child Care Home (FCCH) LPA met with Licensee, Maria Vera and discussed the purpose of the inspection. Licensee provided LPA the tour of the home. There were 6 children and 2 staff present.

On March 24, 2023, FCCH was cited under California Code of Regulations (CCR) 102370(d)(1) Criminal Record Clearance, Licensee' adult child, Adult # 1 does not have a criminal record clearance. Based on record review and licensee's statement, Adult # 1 applied for CRC review on the next business day, 3/27/2023, however, to date Adult #1' s criminal record review/application is still in process and has not cleared.

During today's inspection, Type A deficiency was cited under Title 22 Division 12. Appeal Rights were given and discussed. A civil penalty of $ $2,100.00 was assessed.

LPA Reyes informed licensee Ms. Vera that this report dated 4/14/2023 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.

Continued on LIC 809 C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/14/2023
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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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: 04/14/2023
NARRATIVE
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 Also, LPA Reyes informed the licensee, Ms. Vera to provide a copy of this licensing report dated 4/14/2023 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.

Notice of site visit was issued.

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

DATE: 04/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/14/2023 04:05 PM - It Cannot Be Edited


Created By: Gigi Reyes On 04/14/2023 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: VERA FCC EL TESORO DEL SABER
FACILITY NUMBER: 426215957

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
04/17/2023
Section Cited
CCR
102370(d)(1)

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(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:
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Licensee stated that Adult # 1 has applied for criminal record clearance review on March 27, 2023 and they are waiting for the result. Licensee willl submit a plan of correction on how to prevent commiting the same violation. no later than 4/17/2023
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Licensee's Adult child has no criminal record clearance. This poses an immediate risk to heatlh and safety 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:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 04/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/14/2023


LIC809 (FAS) - (06/04)
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