<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216290
Report Date: 06/05/2023
Date Signed: 06/05/2023 04:54:57 PM

Document Has Been Signed on 06/05/2023 04:54 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:MENDOZA FCC AKA HAPPY WORLD DAYCARE, INC.FACILITY NUMBER:
426216290
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 8DATE:
06/05/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Yesenia MendozaTIME COMPLETED:
04:53 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 06/05/2023 at 11:45 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced One Year Required Inspection of the Family Child Care Home (FCCH) and a change of capacity inspection. LPA met with Isabel Cristina Delgado Garcia, assistant of the FCCH and explained the purpose of the inspection. LPA notes Licensee is out of the home running an errand. At the time of the inspection, LPA observed eight (8) children on site, all of whom are younger than five (5) years of age. LPA notes, Licensee Yesenia Mendoza arrived about 15 minutes from the initiation of this inspection.

LPA, in the company of Licensee toured the interior and exterior of the FCCH. This home is a single-story home that is separated from the daycare area. The home consists of living room, dining room, kitchen, two (2) bedrooms, one (1) bathroom, outdoor yard and separate daycare area that consists of small kitchenette/kitchen area, daycare room and bathroom. Daycare services are offered in the daycare area that consists of kitchenette/kitchen area, daycare area, bathroom, and outdoor yard. LPA notes that the main home is made inaccessible to children by a locked door that needs a key to open.

The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. LPA observed an open face heater that is covered and secured. LPA observed sharps are stored in the kitchen of the main home that is inaccessible to children in care. Medication for the family is also stored in the main kitchen in an elevated cabinet that is inaccessible to children in care. LPA observed cleaning compounds are stored in a locked closet in the daycare area that is not accessible to children in care. The bathroom used for childcare is clean and free of toxins. LPA observed toys, furniture, and equipment in the FCCH are age appropriate and in good condition.

Required forms are predominantly posted on the entrance of the FCCH. LPA observed a smoke and carbon monoxide detectors in the FCCH. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 06/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
Document Has Been Signed on 06/05/2023 04:54 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 06/05/2023 at 03:45 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: MENDOZA FCC AKA HAPPY WORLD DAYCARE, INC.
FACILITY NUMBER: 426216290

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2023

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
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that assistant is not fingerprint cleared or associate to the facility which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 06/06/2023
Plan of Correction
1
2
3
4
Licensee agrees to make sure individual is fingerprinted and clears and agrees to not have assistant present until individual is cleared. Licensee will submit proof of livescan via email to Francisca.Velazquez@dss.ca.gov by 6/6/23.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
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: 06/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2023


LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 06/05/2023 04:54 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 06/05/2023 at 03:45 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: MENDOZA FCC AKA HAPPY WORLD DAYCARE, INC.
FACILITY NUMBER: 426216290

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.5(e)
Staffing Ratio and Capacity
(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on observation, the licensee did not comply with the section cited above in at arrival assistant was providing care and supervision to eight (8) children all under the age of 5 years which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/12/2023
Plan of Correction
1
2
3
4
Licensee agree to submit a written plan detailing how she plans to ensure that she will be within her capacity at all time and will submit via email to Francisca.Velazquez@dss.ca.gov by 6/12/2023.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
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: 06/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2023


LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 06/05/2023 04:54 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 06/05/2023 at 04:11 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: MENDOZA FCC AKA HAPPY WORLD DAYCARE, INC.
FACILITY NUMBER: 426216290

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(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 (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above in that assistant does not have mandated reporter training certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/12/2023
Plan of Correction
1
2
3
4
Licensee agrees to make sure that assistant completes mandated reporter training certificate and submit proof of completed certificate via email to Francisca.Velazquez@dss.ca.gov by 6/12/23.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
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: 06/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2023


LIC809 (FAS) - (06/04)
Page: 5 of 7
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: MENDOZA FCC AKA HAPPY WORLD DAYCARE, INC.
FACILITY NUMBER: 426216290
VISIT DATE: 06/05/2023
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
26
27
28
29
30
31
32
Detectors were tested at 12:30 PM and was found to be operable. The FCCH has a regulation fire extinguisher on site which was purchased on 5/24/2023. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services. The Licensee informed LPA no firearms or ammunition are stored on site.

LPA and licensee toured the outdoor yard. LPA observed the fencing and exit doors to be secured for children in care. LPA observed children yard has plenty of natural shading to afford the children in care. Children have access to filtered water by means of individual water cups. LPA observed there are of outdoor toys that are age appropriate and in good conditions. LPA observed there are no bodies of water on site.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records. LPA reviewed 15-minute sleep logs and found them to be current. A review of the FCCH's fire drill log shows the last drill occurred on 04/15/2023. The Licensee's records were reviewed. Licensee’s pediatric CPR and First Aid certification expires on 01/05/2024. Licensee’s Mandated Reporter training certificate expired on 03/09/2024. LPA reviewed assistant’s file and found that assistant is not fingerprint cleared or associated to the facility. Assistant also does not have mandated reporter training certificate available for review. Lastly, assitant's CPR/First-aid is current and up to date.

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

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 CONT 809-C

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

DATE: 06/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: MENDOZA FCC AKA HAPPY WORLD DAYCARE, INC.
FACILITY NUMBER: 426216290
VISIT DATE: 06/05/2023
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
26
27
28
29
30
31
32
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep asan 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.

On 04/26/2023, the Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 (Small FCCH) to 14 (Large FCCH). The Santa Maria Fire Department granted a fire clearance following an inspection completed at FCCH on 05/26/2023.



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.

The home meets Title 22 of CCR requirements for a Large Family Child Care license effective today. Effective date of license is today 06/05/2023.



A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Yesenia Mendoza in Spanish due to Spanish being licensee’s primary language.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2023
LIC809 (FAS) - (06/04)
Page: 7 of 7