406214901-9-9-2021-17-CC-FVEZ-C6PQ77-20210909115440

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406214901
Report Date: 09/09/2021
Date Signed: 09/09/2021 11:54:46 AM

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:	CERVANTES FAMILY CHILD CARE		FACILITY NUMBER:	406214901
ADMINISTRATOR:	MACRINA CERVANTES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 473-1952
CITY:	OCEANO	STATE: CA	ZIP CODE:	93445
CAPACITY:	14	CENSUS: 1	DATE:	09/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Macrina Cervantes/Juan Cervantes		TIME COMPLETED:	12:00 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 9/9/21, at 10:00 AM, Licensing Program Analyst (LPA), Francisca Velazquez conducted an unannounced Required 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 LPA met with Macrina Cervantes, Licensee of the facility and Juan Cervantes, Spouse and Assistant of the facility and explained the purpose of the inspection. LPA, in the company of Assistant, toured the interior and exterior of the facility. This home is a single level home that consists of three (3) bedrooms, three (3) bathrooms, day care room, kitchen/dinning area, living room, garage and backyard. The garage has two additional rooms that are not being occupied. LPA observed that one room is used for storage, the other room has a bed and random supplies all around the floor. Assistant stated that the room is used for children that live out of town when they are in the area. All adult children are fingerprinted and associated to the facility. Assistant stated that children have access to the day care room, living room, bathroom and backyard, while remainder of the home is excluded from child care. At the time of the inspection, 1 child was present. Required forms are predominantly posted on the wall of the day care room. The home’s living room has a fireplace which is covered inaccessible to children. LPA observed a smoke and carbon monoxide detector in the ceiling of the hallway room. The detectors was tested and found to be operable at 10:18 AM. The home has a regulation fire extinguisher which was service on 11/11/20. LPA 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 a high cabinet in the kitchen which is inaccessible to children. Cleaning compounds are stored under the kitchen sink and in the garage, both of which are inaccessible to children. LPA observed the restroom used for children to be clean and free of toxins with plenty of hand soap, paper towels and hand washing poster for 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: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

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: CERVANTES FAMILY CHILD CARE	FACILITY NUMBER: 406214901
	VISIT DATE: 09/09/2021

NARRATIVE

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The backyard is completely fenced. This facility has a Jacuzzi locked in the backyard. LPA observed that Jacuzzi is located inside a gazebo that is locked. LPA also observed that the gazebo is used as a storage room and had boxes/ chairs and miscellaneous items on top of the covered jacuzzi. LPA observed a shed in the backyard that was locked and inaccessible to children in care. Assistant stated that gardening supplies, paints and household items are stored in the locked shed. 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 are accessible to children in care.

LPA reviewed children records. The records were current, complete and possessed emergency contact information as mandated by regulations and personal rights. LPA reviewed Licensee and Assistant records. Licensee's records are current and complete with CPR and First Aid certifications expiring on 2/29/22 and AB1207 expiring 8/26/22. Assistant's records are current and complete with CPR and First Aid certifications expiring 2/29/22 and AB1207 expiring 7/20/23.

The Licensee possess 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, LPA discussed safe sleep regulations with the Licensee. Licensee has current LIC 9227 and 15 minute log for all infant children enrolled in the facility. Licensee was reminded that it is her responsibility to know the regulations for facility which can be accessed on-line at www.ccld.ca.gov.

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: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC809 (FAS) - (06/04)

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