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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216168
Report Date: 10/06/2023
Date Signed: 10/06/2023 11:57:50 AM

Document Has Been Signed on 10/06/2023 11:57 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:CORREA FCC AKA ALYSSA'S CHILD CAREFACILITY NUMBER:
426216168
ADMINISTRATOR:ALYSSA CORREAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(818) 966-1964
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
10/06/2023
TYPE OF VISIT:Case Management - Legal/Non-complianceUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Alyssa CorreaTIME COMPLETED:
12:00 PM
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On October 6, 2023, at 11:00 AM, Licensing Program Analysts (LPAs) Francisca Velazquez and Elvin Baddley conducted an unannounced Case Management – Legal inspection. LPAs met with licensee, Alyssa Correa and discussed the purpose of the inspection. LPAs and Licensee toured the interior and exterior of the home. LPAs observed 9 children present and 2 adults present during the inspection. Upon arrival, LPAs observed Licensee leaving the home. Per Licensee, she was on her way to pick up 1 child. LPAs note Licensee arrived with 1 children within 10 minutes.

The purpose for this inspection is to deliver the Accusation CDSS No. 6423215102.

A copy of the Accusation Summary indicates the Departments intent of License Revocation. A copy of this Accusation shall be provided to the parent/guardian of currently enrolled child by the next business day or immediately upon return as well as the parent/guardian of any enrolled child until the accusation is either dismissed or resolved through the administrative hearing or stipulated agreement. The following documentation was provided and explained:

· Accusation
· Acknowledgement of Receipt of Licensing Reports (LIC 9224)

No deficiency was cited today. A Notice of Site Visit was issued. Appeal Right were given to Licensee.

Exit interview was conducted and report was reviewed with Licensee, Alyssa Correa in Spanish.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 10/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/06/2023
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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