406215795-2-16-2021-17-CC-EBAY-BYAMQY-20210216084928

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215795
Report Date: 02/12/2021
Date Signed: 02/16/2021 08:49:56 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:	ROJAS FAMILY CHILD CARE		FACILITY NUMBER:	406215795
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 8	DATE:	02/12/2021
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	01:55 PM
MET WITH:	Diana Rojas		TIME COMPLETED:	02:45 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 2/12/21, at 1:55 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management inspection of the above referenced Family Child Care Home (FCCH) for a change of capacity. LPA met with Diana Rojas, Licensee of the FCCH and explained the nature and purpose of the inspection. Due to COVID-19 and the California Department of Public Health's guidelines for social distancing, this inspection was conducted virtually, via the Face Time Application. Prior to the commencement of the tele-inspection, LPA asked Pre screening questions of the Licensee. Licensee's responses to the Pre screening questions suggest no COVID exposures on site. There are eight children present during the inspection. During this tele-inspection, the Licensee provided the LPA an interior and exterior tour of the FCCH. Four of the children on site were sleeping while the remaining four children were participating in distance learning. LPA observed the FCCH's interior and exterior to be free of hazardous materials and toxins which would pose a danger to the children in care. A combination carbon monoxide/smoke detector was tested at the FCCH after the children arouse. The detector was found to be operable. LPA observed a regulation fire extinguisher on site with a service date of 2/6/21. LPA reminded the Licensee to ensure the fire extinguisher is serviced or purchased annually. LPA observed no bodies of water on site and Licensee stated no firearms or ammunition are on site. LPA reviewed the LIcensee's training documentation and found all to be current. The Licensee's First Aid/CPR training certification expires on 4/27/21, while Mandated Reporting training certification expired on 5/2/21. On 1/20/21, the Department received documentation for a FCCH change of capacity. A fire clearance was (CONT. LIC 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2021

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: ROJAS FAMILY CHILD CARE	FACILITY NUMBER: 406215795
	VISIT DATE: 02/12/2021

NARRATIVE

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granted by the Arroyo Grande Fire Department of a capacity of fourteen at the FCCH on 2/4/21.

The home meets Title 22 of Community Care Licensing requirements for a Large Family Child Care License effective today, 2/12/21.

There were no deficiencies cited at this time. LPA provided the Licensee the Notice of Site visit.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2021

LIC809 (FAS) - (06/04)

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