426216168-8-25-2023-17-CC-FVEZ-CV2RMB-20230825130828

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216168
Report Date: 08/25/2023
Date Signed: 08/25/2023 01:08:40 PM

Document Has Been Signed on 08/25/2023 01:08 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:	CORREA FCC AKA ALYSSA'S CHILD CARE		FACILITY NUMBER:	426216168
ADMINISTRATOR:	ALYSSA CORREA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 966-1964
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	08/25/2023
TYPE OF VISIT:	POC	UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Alyssa Correa		TIME COMPLETED:	01:10 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 08/25/2023 at 10:10 AM Licensing Program Analysts, (LPAs) Francisca Velazquez and Elvin Baddley conducted an unannounced Case Management Proof of Correction (POC) Inspection at the Family Child Care Home (FCCH) and met with Licensee, Alyssa Correa. LPAs explained the purpose of the inspection. LPAs observed 8 children being cared by Licensee and Assistant, Adelaida Santos Churape. On 08/14/23 the Licensee/FCCH was cited the following Type A deficiencies: 1. 102425(h) - Car seats shall only be used for transportation purposes and shall not be used for sleeping. On 08/15/23, Licensee submitted written statement detailing that she understands infants can not sleep in car seats and must sleep in appropriate napping equipment. Licensee understand, infants should have their crib or playpen when napping. During today’s inspection, LPAs observe infants sleeping in proper napping equipment. This deficiency is now cleared. 2. 102416.5(a) - (a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. On 8/15/23, Licensee submitted POC via email detailing she will operate within her ratios and capacity and will ensure there is least two staff present at all times. During today's inspection LPAs observed 8 children present with licensee and assistant. This deficiency is now cleared. 3. 102423(a)(2) - Each child receiving services from a family childcare home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. On 08/15/23, Licensee submitted written statement detailing that she will ensure there is enough space and equipment to met the needs of children in care. LPA notes that during this inspection, there was enough space and napping equipment for children in care. This deficiency is now cleared. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

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 08/25/2023 01:08 PM - It Cannot Be Edited

Created By: Francisca Velazquez On 08/25/2023 at 12:28 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: CORREA FCC AKA ALYSSA'S CHILD CARE	FACILITY NUMBER: 426216168
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/25/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/01/2023 Section Cited CCR 102416.1(d)	1 2 3 4 5 6 7	All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review. This requirement is not met as evidenced by	1 2 3 4 5 6 7	Licensee will submit proof of current TB and LIC9108 by 9/1/23 via email to Francisca.Velazquez@dss.ca.gov
	8 9 10 11 12 13 14	Record review revelaed A1 is missing proof of TB and LIC 9108 which poses/posed a potential health, safety or personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: 08/25/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

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: CORREA FCC AKA ALYSSA'S CHILD CARE	FACILITY NUMBER: 426216168
	VISIT DATE: 08/25/2023

NARRATIVE

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On 08/14/2023 the Licensee/FCCH was cited of the following Type B deficiencies:

1. 1596.8662(b)(1) - (1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs. On 08/16/23, Licensee submitted mandated reporter for A1, this deficiency is now cleared.

2. 102416.1(d) - All personnel records shall be maintained at the childcare home and shall be available to the licensing agency for review. Licensee did not submit a plan of correction for this deficiency. During today’s inspection, LPAs reveiwed A1's personnel file and found that A1's personnel file is missing proof of TB and LIC9108. This deficiency is not yet cleared.

3.102418(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. Licensee did not submit proof of correction. During today’s inspection, LPAs conducted child record review and found all children records to be current with immunizations. This deficiency is now cleared.
4. 102417(g)(8) - Each family childcare home shall have a current roster of children as specified in Health and Safety Code Section 1596.84. Licensee did not submit updated facility roster as detailed in the plan of correction. During today's inspection, LPAs conducted record review and found facility roster to be current and updated. This deficiency is now cleared.

5.) 102425(c)(2) - 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. The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the infant’s file and shall be available to the Department for review. Licensee did not submit plan of correction. During today's inspection, Licensee informed LPAs C11 is no longer enrolled in the FCCH. Licensee explained familiy was unable to complete form due to terminating services. Due to C11 no longer being enrolled in the FCCH, this deficiency is now cleared.

CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

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: CORREA FCC AKA ALYSSA'S CHILD CARE	FACILITY NUMBER: 426216168
	VISIT DATE: 08/25/2023

NARRATIVE

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6. 102425(j)(2)(D)(c) - Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check. On 08/15/23 Licensee submitted written statement detailing every infant will have a notebook and staff will be responsible for documenting 15 minute checks. This deficiency is now cleared.

7.) 102419(j) - The licensee shall inform parents or authorized representatives of children in care of their rights, which include, but are not limited to, the following: (j) Copies of the signed receipt shall be available to the Department as provided in Section 102391(d).

The following Type A deficiency are now cleared: CCR 102425(h), CCR 102416.5(a), CCR 102423(a)(2).

The following Type B deficiency are now cleared: HSC 1596.8662(b)(1), CCR 102418(g), CCR 102417(g)(8), CCR 102425(c)(2), CCR 102425(j)(2)(D)(c) and CCR 102419(j).

The following Type B deficiencies have not been cleared. CCR 102416.1(d) - All personnel records shall be maintained at the childcare home and shall be available to the licensing agency for review. During today’s inspection, LPA's record review revealed A1 does not have proof of TB and LIC9108. This deficiency has not been cleared. This is the third time licensee is receiving this deficiency.

Today, deficiencies cited under Title 22 Division 12 Appeal rights given. Civil penalty was accessed for repeat violation and failure to correct. Additional LIC421FC was completed to address civil penalty for $100 per day from the date of 08/14/23.

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

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

LIC809 (FAS) - (06/04)

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