406213554-3-9-2020-17-CC-EBAY-BMJUJC-20200309153719

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406213554
Report Date: 03/09/2020
Date Signed: 03/09/2020 03:37:24 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:	CAMACHO FAMILY CHILD CARE		FACILITY NUMBER:	406213554
ADMINISTRATOR:	VISITACION CAMACHO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 439-3112
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93405
CAPACITY:	14	CENSUS: 5	DATE:	03/09/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Visitacion and Enrique Camacho		TIME COMPLETED:	03:45 PM

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On 03/09/20, at 2:15 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Annual inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Visitacion Camacho, Licensee of the FCCH. The Licensee's spouse/Assistant, Enrique Camacho, was also present during the inspection. The Assistant provided Spanish- English (and vis versa) translation as the Licensee is primarily Spanish speaking. LPA explained the purpose of the inspection and toured the exterior and interior of the FCCH with the Licensee and Assistant. The FCCH's living room, hallway bathroom and front porch are used for child care services, while the home’s second story is excluded from care and barricaded with a child safety gate. At the time of the inspection five children are present.

LPA observed required forms and documents posted on the wall's at the FCCH. The LPA observed operable smoke and carbon monoxide detectors in the FCCH. The FCCH has a regulation fire extinguisher which was last serviced on 03/19/19. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log and observed the last fire/disaster drill occurred on 01/09/20.

The front porch used for child care activities is enclosed by a wrought iron gate. The gate is secure. Play equipment observed in the porch area is age appropriate. No bodies of water were observed on site and the Licensee informed the LPA no firearms or ammunition are stored on site.

The home was orderly and void of hazardous items. Medication and cleaning compounds are stored in the master bedroom which on the second story and inaccessible to children in care. Sharps were observed on a box atop the refrigerator. Toys, furniture and equipment observed in the FCCH are age appropriate.

A sampling of the children records were reviewed. The records were current and complete. A current roster of children was reviewed by the LPA. The children noted in the roster were present and on site. The Licensee's records are also current and complete with Pediatric CPR and First Aid certifications expiring on 06/23/20. LPA informed Licensee of the future development of Mandated Reporter training in Spanish.

CONT. 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2020

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: CAMACHO FAMILY CHILD CARE	FACILITY NUMBER: 406213554
	VISIT DATE: 03/09/2020

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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

LPA reviewed and provided Licensee with a copy of “Child Care Providers Guide to Safe Sleep." LPA reviewed and provided “Effects of Lead Exposure” to be distributed to all families. Licensee was reminded of the responsibility to know the regulations for FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, no deficiencies observed.

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

The report was translated by the Licensee's Assistant/spouse, Enrique Camacho.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2020

LIC809 (FAS) - (06/04)

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