<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216263
Report Date: 04/28/2022
Date Signed: 04/28/2022 05:55:14 PM


Document Has Been Signed on 04/28/2022 05:55 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:SALGUERO FAMILY CHILD CAREFACILITY NUMBER:
406216263
ADMINISTRATOR:IRMA SALGUEROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 931-4366
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY:14CENSUS: 10DATE:
04/28/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
04:46 PM
MET WITH:Irma SalgueroTIME COMPLETED:
06:05 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 4/28/2022, Licensing Program Analysts (LPAs) Gigi Reyes and Martina Jimenez conducted an unannounced Proof of Correction (POC) Inspection at the above Family Child Care Home (FCCH). LPAs asked pre screening questions related to COVID - 19 and licensee's responses indicate there were no exposure on site. There were 10 children and 2 staff during the inspection. Six (6) children were napping when LPAs arrived.

On 4/22/2022, Licensee/FCCH was cited of the following deficiencies:
1. 102416.3(a)(6) - a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed,....
2. 102419(b) (b) The licensee shall post the PUB 394 (8/02), Family Child Care Home Notification of Parents’ Rights Poster in a prominent, publicly accessible area in the family child care home at all times children are in care.

During today's inspection, it was observed that Licensee is now using the identified accessible areas in the operation of Family Child Care Home, Living room, one bedroom, kitchen, dining area and the bathroom by the living room. . It was also observed that all required licensing forms are posted in the wall by the entrance door. Licensee, also submitted a written plan of correction corresponding to the above mentioned citations.

LPAs recommended Licensee to attend the virtual Spanish orientation for refresher purposes which the licensee agreed to.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/28/2022
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: SALGUERO FAMILY CHILD CARE
FACILITY NUMBER: 406216263
VISIT DATE: 04/28/2022
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
26
27
28
29
30
31
32
During today's inspection no deficiencies were cited.

Notice of Site Visit was issued.

The report was reviewed and translated in Spanish by LPA Martina Jimenez.

Exit interview was conducted with Licensee, Irma Salguero.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2