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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 394500249
Report Date: 02/10/2023
Date Signed: 02/10/2023 10:30:21 AM

Document Has Been Signed on 02/10/2023 10:30 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
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:ESQUIVEL, MARIA OLIVIAFACILITY NUMBER:
394500249
ADMINISTRATOR:ESQUIVEL, MARIA OLIVIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 712-9167
CITY:LODISTATE: CAZIP CODE:
95240
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
02/10/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Maria Olivia EsquivelTIME COMPLETED:
10:40 AM
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Licensing Program Analysts (LPA) Erwin Tjhia and Licensing Program Manager (LPM) Bettina Engelman met with Licensee, Maria Olivia Esquivel on 02/10/2022 at 9:45 AM for the purpose of an unannounced plan of correction inspection to clear a Type A deficiency, which was issued on 01/26/2023 for having having an adult without fingerprint clearance at the facility.

All individuals subject to criminal background review have obtained a criminal record clearance. 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.



LPM discussed issues of criminal record clearance, staffing ratio and capacity and Safe Sleep with Ms. Esquivel, and reminded Ms. Esquivel that she can contact her LPA if she ever has questions about regulations or needs resources to stay in compliance. Ms. Esquivel explained that she is working with a San Joaquin First 5 Program on resources and tips to help her follow Title 22 regulations, offer an age-appropriate curriculum and maintain a safe environment to meet children's needs.

During today's inspection LPA and LPM toured all areas accessible to children in care and observed 5 preschoolers and one school age child being supervised by the Licensee and her assistant. Licensee is aware that if an assistant is unavailable, the Licensee reverts back to the requirements of a small license capacity and ratio. LPA reviewed the LIC 9224 acknowledgment forms signed by parents.

Deficiency cited on 01/26/2023 is cleared effective today. Proof of correction letter was provided. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Erwin Tjhia
LICENSING EVALUATOR SIGNATURE: DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/10/2023
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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