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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217271
Report Date: 01/10/2025
Date Signed: 01/10/2025 11:11:50 AM

Document Has Been Signed on 01/10/2025 11:11 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:CORREA FAMILY CHILD CAREFACILITY NUMBER:
426217271
ADMINISTRATOR/
DIRECTOR:		ESPERANZA CORREA TELLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 268-1854
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
01/10/2025
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:29 AM
MET WITH:Esperanza Correa TIME VISIT/
INSPECTION COMPLETED:
11:25 AM
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This is a change of location. Previous facility number is 426215866.

On January 10, 2025 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an announced Prelicensing inspection at the above-mentioned residence. LPA met with applicant Esperanza Correa and informed them the purpose of the inspection. At the time of the inspection no children were present. Applicant informed LPA the intention to provide care for children ages 0-13 years old. Applicant informed LPA the intention to have operating hours of 12AM - 11:59PM, Monday through Sunday.



LPA in the company of the applicant toured the interior an exterior of the residence in its entirety. The residence is a single story home consisting of 3 bedroom, 3 bathrooms, 2 living rooms, dining room, kitchen, attached garage and backyard. The home will be using the master bedroom, bathroom located in the master bedroom and a section of the backyard for child care purposes, while the remainder of the home will be excluded from care.

LPA observed the master bedroom to be clean and free of hazards. LPA observed the area to have sufficient children's toys and equipment for children in care. LPA observed the area to have sufficient space and ventilation for children in care. LPA observed the door to the rest of the home has the ability to be secured. LPA reminded applicant, in order for the rest of the home to be inaccessible to children the door to the rest of the home must be secured when children are present. LPA observed the bathroom in the children's area to be clean and free of hazard as well. LPA observed all the doors to bedrooms and closets in the remainder of the home to have child safe locks. LPA observed the cleaning supplies and sharps to be stored in an elevated kitchen cabinet.

LPA observed only a part of the backyard will be used for child care purposes. LPA observed the children's area to be completely separated from the inaccessible side of the yard with a fence. LPA observed the
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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/10/2025
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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426217271
VISIT DATE: 01/10/2025
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children's side to have the ability to be secured. LPA observed the children's yard to be clean and free of hazards.

LPA observed a fire extinguisher that satisfies regulation (3A40BC) that was purchased 11/19/2024. LPA reminded applicant to purchase or service a regulation fire extinguisher annually. LPA observed a smoke and carbon monoxide detector which was tested at 9:48 AM and found to be operational. Applicant informed LPA that there are no firearms in the home. Applicant completed Mandated Reporter training on 4/6/24 , and CPR/First aid was completed on 12/10/23. LPA reminded applicant it is their responsibility to maintain current training and certificates.

The applicant provided proof of control of property.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) or (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.

LPA reviewed with applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant 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.


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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CORREA FAMILY CHILD CARE
FACILITY NUMBER: 426217271
VISIT DATE: 01/10/2025
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On this date, 1/10/2025, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.
To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPA reminded applicant the Stipulation and Waiver Order dated August 2, 2024 (CDSS No. 6423215103 OAH 2023120056) shall be provided to parents.

The home meets Title 22 of CCR requirements for a Large Family Child Care License. Effective date of the license will be noted as the present 1/10/2025.

Exit interview conducted and report was reviewed with the applicant Esperanza Correa . Notice of Site Visit was given.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025
LIC809 (FAS) - (06/04)
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