406215057-7-8-2021-17-CC-MKST-C4QSJH-20210708135511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215057
Report Date: 07/08/2021
Date Signed: 07/08/2021 01:55:18 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:	MENDOZA FAMILY CHILD CARE		FACILITY NUMBER:	406215057
ADMINISTRATOR:	MARIA MENDOZA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 473-2802
CITY:	OCEANO	STATE: CA	ZIP CODE:	93445
CAPACITY:	14	CENSUS: 4	DATE:	07/08/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria Mendoza		TIME COMPLETED:	02:00 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 7/8/21, at 1:00 PM, Licensing Program Analyst (LPA) Melissa Stewart and 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 LPAs met with Maria Mendoza, Licensee of the FCCH and explained the purpose of the inspection. LPAs, in the company of Licensee, toured the interior and exterior of the FCCH. This home consists of three (3) bedrooms, two (2) bathroom single level home. The home’s living/family room, backyard and restroom are used for child care services, while remainder of the home is excluded from child care. At the time of the inspection, 4 children are present. Required forms are predominantly posted on the wall at the entry of the home. The home’s living room has a fireplace which is barricaded by a child safety gate and inaccessible to children. LPAs observed a smoke and carbon monoxide detector in the ceiling of the living/family room. The detector was tested and found to be operable at 1:12 PM. The home has a regulation fire extinguisher which was service on 1/26/21. LPAs 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 Licensee's room which is inaccessible to children. Cleaning compounds are stored in the laundry room which is inaccessible to children. Toys, furniture and equipment observed in the home are safe, varied and age appropriate. The backyard is completely fenced. LPAs observed a shed in the backyard that was locked and inaccessible to children in care. LPAs observed plastic slide with plenty of cushion provided by artificial grass. 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 were observed on site. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

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: MENDOZA FAMILY CHILD CARE	FACILITY NUMBER: 406215057
	VISIT DATE: 07/08/2021

NARRATIVE

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This home has been licensed as a large FCCH since 8/11/2016; fire clearance was granted on 7/22/2016. Licensee stated that her garage has been permitted and she would like to start using it for daycare services. LPAs informed Licensee that garage will need a fire clearance prior to being used in the daycare. Licensee will inform LPA when her garage is ready for fire inspection. Licensee understands that garage may not be used until clearance from Fire Department has been granted.

LPA reviewed children records. The records were current, complete and possessed emergency contact information as mandated by regulations. The Licensee's records are also current and complete with CPR and First Aid certifications expiring on 12/18/22. LPAs observed a Mandated Reporter Certification which expires on 4/25/22.

The Licensee possess no firearms or ammunition and 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, LPAs discussed safe sleep regulations with the Licensee. Licensee was reminded that it is her responsibility to know the regulations for FCCH which can be accessed on-line at www.ccld.ca.gov. Licensee shared that she contracts with CAPSLO's Early Head Start program and participates in monthly training's and stays up-to-date with all of Licensing regulations.

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: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

LIC809 (FAS) - (06/04)

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