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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215641
Report Date: 09/01/2022
Date Signed: 09/02/2022 02:06:49 PM

Document Has Been Signed on 09/02/2022 02:06 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:ESQUIVIAS FAMILY CHILD CAREFACILITY NUMBER:
406215641
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/01/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Alma EsquiviasTIME COMPLETED:
10:41 AM
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Due to COVID-19 pandemic, LPA asked the pre-screening questions prior to inspection. Licensee's responses indicate there was no COVID-19 exposure on site.

On 9/1/22, at 9:40 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Case Management inspection of the above referenced Family Child Care Home (FCCH) for a change of capacity. LPA met with Alma Esquivias, Licensee of the FCCH and explained the nature/purpose of the inspection. LPA notes that there were no children present during this inspection.

During this inspection, LPA and Licensee together toured the and interior and exterior of the FCCH. LPA observed the FCCH's interior and exterior to be free of hazardous materials and/or toxins at the time of the visit. LPA observed cleaning compounds located under the sink in the kitchen and in the laundry room, both areas were observed to be inaccessible to children. Sharps and medication were observed in an elevated cabinets in the kitchen that are inaccessible to children in care.

LPA reviewed the Licensee’s First Aid/ CPR certification which expires on 06/11/2024. LPA observed a regulation fire extinguisher which was serviced on 09/24/2022. LPA reviewed the Licensee’s Mandated Reporter Training certificate, which was completed on 07/06/24.

On 07/15/22, the Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 (Small FCCH) to 14 (Large FCCH). The San Luis Obispo County Fire Department granted a fire clearance following an inspection completed at FCCH on 08/25/2022.

The home meets Title 22 of CCR requirements for a Large Family Child Care license effective today. Effective date of license is today September 1, 2022. LPA provided the Licensee a Notice of Site Visit (LIC 9213) to be posted. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/01/2022
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: ESQUIVIAS FAMILY CHILD CARE
FACILITY NUMBER: 406215641
VISIT DATE: 09/01/2022
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This inspection visit was conducted in Spanish by LPA Velazquez due to Licensee being primarily Spanish speaking.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2022
LIC809 (FAS) - (06/04)
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