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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406213554
Report Date: 02/06/2023
Date Signed: 02/06/2023 01:00:19 PM


Document Has Been Signed on 02/06/2023 01:00 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:CAMACHO FAMILY CHILD CAREFACILITY NUMBER:
406213554
ADMINISTRATOR:VISITACION CAMACHOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 234-4983
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY:14CENSUS: DATE:
02/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Visitacion and Enrique CamachoTIME COMPLETED:
12:00 PM
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On 2/6/23, at 9:15 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required 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 is a two story townhouse. The FCCH's living room,kitchen, 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 no children are present.

The home is orderly and void of hazardous items. Cleaning compounds are stored in a secure cabinet underneath the kitchen sink, while sharps are observed atop of the kitchen refrigerator which is beyond the reach of children. Medication in the home is stored in the the home's master bedroom which is an excluded area of the FCCH. Toys, furniture and equipment observed in the FCCH are age appropriate.

LPA observed required licensing forms and documents posted on the wall's at the FCCH. LPA observed an operable smoke and carbon monoxide detectors in the FCCH which were tested at 10:06 AM. The FCCH has a regulation fire extinguisher (2A10BC )which was last serviced on 2/23/22. 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 8/27/22.

The front porch area is used for outdoor activities. The area is enclosed by a wrought iron gate and stucco walls. The gate is secure. Play equipment observed in the porch area is age appropriate. No bodies of water were observed on site, however the complex where the FCCH is housed has a community swimming pool which is enclosed by fencing. The Licensee informed LPA the swimming pool is not used by children in care.

(CONT.809-C, Page 2)

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2023
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: CAMACHO FAMILY CHILD CARE
FACILITY NUMBER: 406213554
VISIT DATE: 02/06/2023
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 Although no children are on site, LPA reviewed children records. The records were current and complete. A current roster of children was reviewed by the LPA. The FCCH had documentation capturing children's sleep in 15 minute intervals and well as emergency contact information. The Licensee's records are also current and complete with Pediatric CPR and First Aid certifications expiring on 1/15/24. The Licensee completed Mandated Reporter training on 2/6/23. Licensee informed the LPA no firearms or ammunition are stored on site.

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: http://www.ada.gov/childqanda.htm



Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as for additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Visitacion Camacho.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023
LIC809 (FAS) - (06/04)
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