406207770-7-8-2021-17-CC-MKST-C4QTQJ-20210708145601

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406207770
Report Date: 07/08/2021
Date Signed: 07/08/2021 02:56:13 PM

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:	PEREZ FAMILY CHILD CARE		FACILITY NUMBER:	406207770
ADMINISTRATOR:	MARIANA PEREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 481-4863
CITY:	OCEANO	STATE: CA	ZIP CODE:	93445
CAPACITY:	14	CENSUS: 9	DATE:	07/08/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:03 PM
MET WITH:	Mariana Perez		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 7/8/21, at 2:03 PM, Licensing Program Analyst (LPA) Melissa Stewart and LPA Francisca Velazquez conducted an unannounced Required 1 Year inspection of the facility. Prior to inspection, LPA completed COVID-19 pre-screening questionnaire with Licensee, based on responses it was determined that there are no COVID-19 exposures in the facility. The LPAs met with Mariana Perez, Licensee of the FCCH and explained the purpose of the inspection. LPAs, in the company of Licensee, toured the interior and exterior of the FCCH. This home consists of three (3) bedrooms, three (3) bathroom and permitted garage. Licensee mainly uses garage for daycare services. Garage is permitted and has a children's restroom. The home is inaccessible to children in care. At the time of the inspection, 9 children are present. Licensee stated that she provides services Monday - Saturday from 6 AM- 6PM. Licensee stated that at the moment she does not have any children receiving services on Saturday but she does offer services if needed. Required forms are predominantly posted on the wall of the facility. LPAs observed a smoke and carbon monoxide detector in the ceiling of the facility. The detectors were not tested due to children napping. Licensee shared that she conducts emergency drills every month and changes the batteries to both smoke and carbon monoxide detectors. The home has a regulation fire extinguisher which was serviced on 4/9/21. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services. The home was clean, orderly and has ventilation to afford for the children’s comfort and safety. Further, the home was void of hazardous items. Medication in the home is stored in Licensee's room which is inaccessible to children. Cleaning compounds are stored in the laundry room and under the kitchen sink, both are inaccessible to children. Toys, furniture and equipment observed in the home are safe, varied and age appropriate. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: PEREZ FAMILY CHILD CARE	FACILITY NUMBER: 406207770
	VISIT DATE: 07/08/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The backyard is completely fenced. LPAs observed a shed in the backyard that was locked and inaccessible to children in care. LPAs observed plenty of shade, gross motor activizes with cushion accessible to children in care. The fence’s entry/exit gates were secure. Toys and play equipment observed in backyard are safe, varied, age appropriate and in satisfactory condition. No bodies of water were observed on site.

LPA reviewed children records. The records were current, complete and possessed emergency contact information as mandated by regulations. The Licensee's records are also current and complete with CPR and First Aid certifications expiring on 2/12/23. LPAs observed a Mandated Reporter Certification which expires on 6/27/22.

The Licensee possess no firearms or ammunition and no firearms or ammunition are stored on site.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm

LPAs discussed COVID-19 best practices and guidance. Likewise, LPAs discussed safe sleep regulations with the Licensee. Licensee was reminded that it is her responsibility to know the regulations for FCCH which can be accessed on-line at www.ccld.ca.gov. Licensee shared that she contracts with CAPSLO's Early Head Start program and participates in monthly training's and stays up-to-date with all of Licensing regulations.

There were no deficiencies cited at this time.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2