406208842-7-26-2021-17-CC-FVEZ-C5AU4X-20210726151553

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406208842
Report Date: 07/26/2021
Date Signed: 07/26/2021 03:15:58 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:	PLASCENCIA FAMILY CHILD CARE		FACILITY NUMBER:	406208842
ADMINISTRATOR:	JOSEFINA PLASCENCIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 474-9801
CITY:	OCEANO	STATE: CA	ZIP CODE:	93445
CAPACITY:	14	CENSUS: 3	DATE:	07/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Josefina Plascenia		TIME COMPLETED:	03:20 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 7/26/21 at 2:20 PM, Licensing Program Analyst (LPA) Francisca Velazquez and Licensing Program Manager (LPM) Maria Mueller conducted an unannounced Required Inspection of the facility. Prior to entering the facility, LPA conduct COVID-19 questionnaire, and based on Licensee’s responses it was determine that that facility did not have any COVID-19 exposures. LPA met with Josefina Plascencia, Licensee of the facility and explained the purpose of the inspection. LPA in the company of the Licensee, toured the interior and exterior of the home. This is a two (2) story home with four (4) bedrooms, two in a half (2.5) bathrooms, dining room, kitchen, living room, and day-care garage. Licensee stated that children have access to the first floor of the home including the garage while the second floor is off limits to the children in care. During the time of the inspection, Licensee was caring for three (3) children. LPA observed required forms posted in the walls of the living room. The day care room has plenty manipulative and material for children in care. LPA observed smoke and carbon monoxide detectors in the facility. Licensee tested carbon monoxide detector and was found to be operational at 2:23 PM. Smoke detector was not checked as it was too high in the ceiling and Licensee could not reach. LPA observed that smoke detector had green light indicating that it is operational. Licensee stated that batteries to both carbon monoxide and smoke detector were changed one month ago. The home has a regulation fire extinguisher which was serviced on 4/9/21. LPA reminded Licensee that fire extinguisher needs to be either service or purchase annually. The home maintains working telephone services. LPA observed a small gate located at the bottom of the stairway making the second floor inaccessible to children in care. LPA observed cleaning supplies stored in a high cabinet in the kitchen and in the garage in a high cabinet, both areas are inaccessible to children in care. The facility is orderly, clean and has ventilation for child care services. The restroom used for children was found to be clean and orderly. Medication in the facility is stored in a high cabinet in the kitchen and is inaccessible to children in care. Toys and equipment observed in the facility are age appropriate. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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: PLASCENCIA FAMILY CHILD CARE	FACILITY NUMBER: 406208842
	VISIT DATE: 07/26/2021

NARRATIVE

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Licensee stated that children have access to the backyard for outdoor play. Licensee stated that children are always supervised when playing in the backyard. LPA reminded Licensee of the importance of having direct supervision when children are engaged in outside play. LPA observed a small locked shed located in the backyard. Licensee stated that the shed is always locked during day-care hours. LPA observed plenty of shade and gross motor actives for children in day-care. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the facility.

A sampling of the children's record were reviewed and found to have current and up to date with emergency information cards. The Licensee's has current Mandated Reporter training certificate that expires 6/23/22. LPA reminded Licensee that Mandated Reporter training certificate has to be updated every two (2) years. Licensee has current CPR and First Aid certifications that will expired 2/12/23. Last emergency drill was conducted on 7/23/21. LPA's reminded Licensee that emergency drills are required every six (6) months and need to be documented.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

LPA discussed COVID 19 guidance and best practices with the Licensee. LPA discussed safe sleep regulations and Individual Infant Sleep Plan LIC 9227. Licensee stated that she does not have any infant age children enrolled in her facility. Licensee also stated that she was aware of the new sleep regulations and has taken a training courses offered by the local resource and referral office. Licensee was reminded that it is Licensee's responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited during today's visit.

Report was read to Licensee, Josefina Plascencia in Spanish by LPA Velazquez as Licensee is primarily Spanish speaking.

LPA provided Licensee with Notice of Site visit (LIC 9213) which was posted by the Licensee.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

LIC809 (FAS) - (06/04)

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