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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216477
Report Date: 10/02/2024
Date Signed: 10/02/2024 02:12:48 PM

Document Has Been Signed on 10/02/2024 02:12 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:ASUAJE FAMILY CHILD CAREFACILITY NUMBER:
426216477
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/02/2024
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Veronica AsuajeTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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Licensing Program Manager (LPM) Ana Tolentino and Licensing Program Analysts (LPAs) Sylvia Mendoza-Ceja and German Negrete met with Veronica Asuaje to conduct an Informal Conference at the Department of Social Services Regional Office. The purpose of the conference is to discuss the observed during inspections to the home for the Annual Random conducted on June 6, 2024 and POC Inspection on August 20, 2024 to the Asuaje Family Child Care Home.


1) 102370(d)(1)&(e) Criminal Record Clearance: Licensee allowed an adult to move in the home and provide care to children prior to obtaining a criminal record clearance though the Department, cited 6/6/2024 and $500.00 civil penalty assessed.

2) 102416.5(a)(b)12 Staffing Ratio and Capacity: Licensee and her assistant were providing care for eight children of which 5 were infants (under age 2), cited 6/6/2024.

3) 102417(g)(1)&(4) Operation of a FCCH: Two bedroom doors open and another bedroom door closed and were accessible to day care children. In two of the bedrooms, LPA observed over the counter medicines and vitamins accessible to day care children. The 2 A10BC Fre Extinguisher did not have a service tag. Licensee stated she had it serviced in 2022, cited 6/6/2024.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Sylvia Ceja
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: ASUAJE FAMILY CHILD CARE
FACILITY NUMBER: 426216477
VISIT DATE: 10/02/2024
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4) 1597.622 (a) (1) Health and Safety: Licensee failed to obtain verification of measles, pertussis, and flu (or decline flu) for her assistant, cited 6/6/2024.

5) 102369(b)(9) Application for Initial License: Failure to obtain evidence of a current tuberculosis clearance prior to assistant providing care care/moving into the home, cited 6/6/2024.

6) 1596.8662(b)(1) Child Abuse Mandated Reporter Training: Licensee's Child Abuse Mandated Reporter Training expired. In addition, her assistant had not completed the training, cited 6/6/2024.

7) 102417(g)9(A)1 Operation of a Child FCCH: Licensee failed to complete and document fire drill as required, cited 6/6/2024.

8) 102425 j2 (D) Infant Safe Sleep: Licensee failed obtain document and maintain records of the 15 minute infant sleep chart of the infants in care, cited 6/6/2024 and 8/20/2024.

9) 102421(a) Child's Records: Review of children's files revealed the licensee failed to maintain children's files and has also accepted a child without obtaining child's records prior to caring for the child, cited 6/6/2024 and 08/20/2024.

10) 102425(c) Infant Safe Sleep Plan: An individual Infant Sleeping Plan (LIC9227) shall be completed for each infant up to 12 months, cited 8/20/2024.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Sylvia Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: ASUAJE FAMILY CHILD CARE
FACILITY NUMBER: 426216477
VISIT DATE: 10/02/2024
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In response to these discussions, Licensee Veronica Asuaje has agreed to the following.

· All adults living in the home or providing care to children shall obtain a criminal record clearance prior to working with children.
· All adults living in the home or providing care to children shall obtain a TB Test and Clearance within 1 year prior to working with children or moving into the home.
· All care providers shall obtain verification of measles, pertussis and flu (or decline flu in
writing).
· Child Mandated Reporter Training AB1207 shall be current at all times for licensee and
assistant and completed every 2 years.
· Licensee shall not exceed the limitations of the small family child care license.
· The off-limit bedrooms shall remain inaccessible to day care children at all times.
· The 2 A10 BC Fire Extinguisher shall be serviced or replaced yearly.
· Infant Safe Seep Plan (LIC9227) shall be completed for each infant up to 12
months. Shall be in file prior to attendance to day care and shall be in child's file.
· Infant Safe Sleep Chart, 15 minute log, shall be completed for all infants in care,
and shall be filed in child's file.
· Children's Records shall be complete for each child and shall be maintained for
3 years.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Sylvia Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: ASUAJE FAMILY CHILD CARE
FACILITY NUMBER: 426216477
VISIT DATE: 10/02/2024
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· Licensee shall attend 10 Hours of training in the areas of Family Child Care Best Practices, Children's RecordKeeping Requirements, and other training related to care and supervision of children with the local Child Care Resource and Referral Agency by 10/16/2024.
· Licensee shall attend Family Child Care Orientation by 10/16/2024.

Increased unannounced visits to monitor compliance in the licensed family child care home.

Licensee was provided a pamphlet for Technical Support for the day care.

Upon receipt, Licensee shall post and provide copies of this licensing report: to parents/guardians of children in care at the facility and to parents/guardian of children newly enrolled at the facility during the next 12 months. Licensee shall obtain signatures of parents/guardian on the Acknowledgement of Receipt of Licensing Reports LIC 9224.



Appeal Rights were reviewed with Licensee. Report was reviewed in Spanish with Licensee.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Sylvia Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
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