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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216561
Report Date: 02/02/2024
Date Signed: 02/02/2024 05:31:17 PM

Document Has Been Signed on 02/02/2024 05:31 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:SANTOS FCC AKA DAHLIA'S FAMILY CHILD CAREFACILITY NUMBER:
426216561
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
02/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:01 PM
MET WITH:Dalia Lizbeth SantosTIME COMPLETED:
05:40 PM
NARRATIVE
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Licensing Program Analyst (LPA) Martina Jimenez made an unannounced inspection to initiate a complaint investigation. A Case Management - Deficiency was identified during the inspection. LPA met with Dalia Lizbeth Santos, licensee, and Paula Ramirez-Ramirez, Assistant.

LPA observed 5 children in care at the time of the inspection. The purpose of the inspection was discussed with the licensee, and together LPA and licensee toured the facility inside and out of the home.

A tour of home revealed ants in the children bathroom. LPA observed in the bedroom#1, Bedroom #2, & Bedroom#4, doors open and accessible to the children in care. LPA observed personal hygiene products, peroxide, hair care products, medications, Raid fly ribbon, and Resolve pet carpet cleaner. LPA observed in the kitchen two potato peelers and a knife accessible to the children in care.

A tour of the play yard was conducted and no bodies of water were observed. The licensee stated there are no guns and /or ammunition in the home.

Today’s visit was conducted in Spanish. 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 LIC 809 and LIC 809 D.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 02/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/02/2024
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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Document Has Been Signed on 02/02/2024 05:31 PM - It Cannot Be Edited


Created By: Martina Jimenez On 02/02/2024 at 04:56 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: SANTOS FCC AKA DAHLIA'S FAMILY CHILD CARE
FACILITY NUMBER: 426216561

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/05/2024
Section Cited
CCR
102417(g)(4)

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102417(g)(4) Operation of a Family Child Care Home. Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger to children shall be stored where they are inaccessible to children. LPAs observed bedroom#1, Bedroom #2, & Bedroom#4,
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Licensee will submit a plan of correction on how toxins will be made inaccessible to children by February 5, 2024, via email to Martina.Jimenez@dss.ca.gov
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personal hygiene products, peroxide, hair care products, medications, Raid fly ribbon, and Resolve pet carpet cleaner. LPA observed in the kitchen two potato peelers and a knife accessible to the children in care. This poses an immediate health and safety risk to children in care.
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Type A
02/05/2024
Section Cited
CCR102424(a)(2)

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Each child receiving services from a family child care 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: To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

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Licensee will submit a plan of correction on how licensee will prevent future incidents to CCLD by February 5, 2024, via email to Martina.Jimenez@dss.ca.gov
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LPA observed ants in the children bathroom. This poses an immediate health and safety risk to 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:Martina Jimenez
LICENSING EVALUATOR SIGNATURE:
DATE: 02/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/02/2024


LIC809 (FAS) - (06/04)
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