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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406211177
Report Date: 03/23/2022
Date Signed: 03/23/2022 03:55:45 PM


Document Has Been Signed on 03/23/2022 03:55 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:MENDOZA FCC AKA LITTLE STARS CHILDREN DAYCAREFACILITY NUMBER:
406211177
ADMINISTRATOR:YADIRA MENDOZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 674-9691
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:14CENSUS: 11DATE:
03/23/2022
TYPE OF VISIT:Case Management - COVID-19UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Yadira Mendoza TIME COMPLETED:
04:00 PM
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On 3/23/22, at 3:00 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Case Management – COVID-19 inspection and met with Yadira Mendoza, Licensee of the abovementioned Family Child Care Home (FCCH). LPA informed Licensee of the purpose of the inspection and completed a COVID-19 pre-screening questionnaire prior to the commencement of the inspection. LPA notes that prior to Licensee allowing LPA in the home, Licensee conducted pre-screening questionnaire and took LPA's temperature. LPA along with Licensee, toured the facility, inside and outside.

This inspection is a follow-up to COVID-19 outbreaks reported by facility staff to CCLD between 1/10/22 to 2/10/22. CCLD provided a Tele - Rapid Assistance Support Team (RAST) inspection on 9/10/2020, where CCLD provided COVID-19 resources, current Childcare Industry Guidance, and a COVID-19 self-assessment guide to the facility.

LPA observed the Licensee and Assistant wearing a face covering upon arrival at the facility. The children in care (11) were napping. LPA observed the napping children on mats were amply distant from each other. The FCCH has disinfectants and cleaning compound readily available to staff members but inaccessible to children in care. COVID posting related to mitigations were observed throughout the FCCH. Temperatures of individuals entering the FCCH are taken outside the entry of the FCCH and sanitizing items are available outdoor near the entry of the home.

LPA discussed facility’s written plan when a staff member or child tests positive for COVID-19 and developing a written communication plan with parents/guardians to share information and guidelines in their preferred language. LPA discussed COVID-19 Vaccines, Testing, Face coverings, Essential Protective Equipment and Supplies, Physical Distancing, Ventilation, Isolation for Illness, Cleaning and Disinfection, Hand washing, Food Service and Meal Times, How to Respond to Exposures or Outbreaks, and Resilience Tips during the Pandemic. CONT 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2022
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: MENDOZA FCC AKA LITTLE STARS CHILDREN DAYCARE
FACILITY NUMBER: 406211177
VISIT DATE: 03/23/2022
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LPAs reviewed that facility maintains a current COVID-19 Child Care Program Self-Assessment Guide/Mitigation plan. LPA also provided the following resources:
- PIN 22-10-CCP dated 3/18/22- Updated Guidance For Child Care Providers Regarding Coronavirus Disease (COVID-19).
- Official Public Health and Child Care Guidance for COVID-19 – Updated 2/28/22.
- COVID-19 Child Care Resources:
https://www.cdss.ca.gov/inforesources/cdss-programs/community-care-licensing/child-care-licensing/covid-19-child-care-resources

There were no deficiencies cited during today's inspection.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with Licensee, Yadira Mendoza.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 03/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2