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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073408592
Report Date: 06/05/2025
Date Signed: 06/05/2025 03:08:36 PM

Document Has Been Signed on 06/05/2025 03:08 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
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ORANTES, EDGAR AND SANTAMARIA, OCTAVILAFACILITY NUMBER:
073408592
ADMINISTRATOR/
DIRECTOR:		ORANTES, EDGARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 516-6673
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
06/05/2025
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Octavila SantamariaTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced case management inspection. The purpose of the inspection was to ensure compliance with AB2866 pool safety requirements. LPA met with Octavila Santamaria. A fingerprint cleared assistant is also present today. Edgar Orantes was not present during the visit. LPA spoke to Edgar Orantes on the telephone. Mr. Orantes stated that he took the day off. LPA reminded Mr. Orantes that he is required to be present in the home during child care hours and temporary absence shall need exceed 20 percent of the hours that the facility is providing care per day.

During the inspection LPA observed a mesh fence which surrounded the pool. The mesh fence has a self closing gate that opens away from the pool. Licensee has a pool alarm, however the alarm was not properly functioning during the visit. Licensee has a rescue pole, however it does not meet the requirements specified in Health and Safety Code 1596.814. Licensee has not began logging daily inspections of the pool as required. LPA observed a life ring that is United States Coast Guard approved.

During the inspection LPA observed children napping in a room with the door closed. One of the children in the room was an infant. C1 was drinking a bottle while lying in the play yard.

The attached type A violation is cited today and must be corrected by the due date. 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/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.

See 809-D for deficiencies cited today.
Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Edgar Orantes over the telephone as Octavila Santamaria does not speak English.
NAME OF LICENSING PROGRAM MANAGER: Sherelle Johnson
NAME OF LICENSING PROGRAM ANALYST: Cherie Acosta
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/05/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 06/05/2025 03:08 PM - It Cannot Be Edited


Created By: Cherie Acosta On 06/05/2025 at 01:29 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ORANTES, EDGAR AND SANTAMARIA, OCTAVILA
FACILITY NUMBER: 073408592

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/06/2025
Section Cited
CCR
102425(b)

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Infant Safe Sleep. Cribs or play yards shall be free from all loose articles and objects. This requirement was not met as evidenced by: C1 was in the play yard drinking a bottle which is an immediate risk to the health and safety of children in care.
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Both licensees shall review safe sleep regulations. Licensees shall submit a self certified letter to CCL by 6/6/25 ensuring they will remain in compliance with all safe sleep regulations.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
06/06/2025
Section Cited
HSC1596.814(a)(1)(B

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1596.814(a)(1)(B)(ii)(I) Family daycare home; in-ground swimming pool requirements.A licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements:The swimming pool shall be equipped with, at minimum, the following drowning prevention safety features:
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Licensee shall ensure pool alarm meets the requirements specified in Health and Safety Code. Licensee shall submit a letter to CCL 6/19/25 ensuring they are in compliance.
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n addition to the characteristics described in subparagraph (A), at least one of the following:An alarm that, when placed in a swimming pool, will sound upon detecting an entrance into the water. The alarm shall be turned on and be in working condition during a facility’s operating hours while the swimming pool is not in use. This requirement was not met as evidenced by:Alarm was not functioning properly during visit which is a potential risk to the health and safety od children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sherelle Johnson
NAME OF LICENSING PROGRAM MANAGER:
Cherie Acosta
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 06/05/2025 03:08 PM - It Cannot Be Edited


Created By: Cherie Acosta On 06/05/2025 at 02:01 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ORANTES, EDGAR AND SANTAMARIA, OCTAVILA
FACILITY NUMBER: 073408592

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2025
Section Cited
HSC
1596.814(a)(2)(B)

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Family daycare home; in-ground swimming pool requirements licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements:
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Licensee shall obtain a rescue pole that meets the requirements specified in Health and Safety Code. Licensee shall send proof to CCL by 6/19/25
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The licensee shall have the following safety equipment visible from the swimming pool and readily available for immediate use.A rescue pole with a body hook and a minimum fixed length of 12 feet. This requirement was not met as evidenced by: Licensees has a pole that is adjustable and not a fixed length which is a potential risk to the health and safety of children in care.
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 Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Type B
06/19/2025
Section Cited
HSC1596.814(a)(3)

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Family daycare home; in-ground swimming pool requirements licensed family daycare home operated at a private single-family dwelling with an in-ground swimming pool on the premises shall comply with all of the following requirements:
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Licensee shall begin preforming daily pool inspections prior to opening each day to ensure compliance with AB2866 pool safety requirements. Licensee shall submit a copy of the log to CCL by 6/19/25
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A licensee shall perform a daily inspection of the drowning prevention safety features and safety equipment before opening the facility and maintain a log of the inspections to be provided to the department upon request.This requirement was not met as evidenced by:licensee does not have a pool inspection log which is a potential risk to the health and safety of children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Sherelle Johnson
NAME OF LICENSING PROGRAM MANAGER:
Cherie Acosta
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2025


LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 06/05/2025 03:08 PM - It Cannot Be Edited


Created By: Cherie Acosta On 06/05/2025 at 02:21 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
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ORANTES, EDGAR AND SANTAMARIA, OCTAVILA
FACILITY NUMBER: 073408592

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/19/2025
Section Cited
CCR
102417(a)

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Operation of a Family Child Care Home.The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for
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 Edgar Orantes shall ensure he is present in the home during operating hours and temporary absence shall not exceed 20 percent of the hours that the facility is providing care per day. Mr. Orantes shall submit a self certified letter to CCL by 6/19/25 ensuring he understands and shall remain in compliance.
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and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement was not met as evidenced by: Edgar Orantes was not present in the home today which is a potential risk to the health and safety of children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.

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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.
Sherelle Johnson
NAME OF LICENSING PROGRAM MANAGER:
Cherie Acosta
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 06/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/05/2025


LIC809 (FAS) - (06/04)
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