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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426210089
Report Date: 01/31/2020
Date Signed: 01/31/2020 01:20:01 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:ANDALON FAMILY CHILD CAREFACILITY NUMBER:
426210089
ADMINISTRATOR:ROSA ANDALONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 686-1529
CITY:SANTA YNEZSTATE: CAZIP CODE:
93460
CAPACITY:14CENSUS: 3DATE:
01/31/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Rosa AndalonTIME COMPLETED:
01:25 PM
NARRATIVE
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Licensing Program Analyst (LPA) Ruth Gull made an unannounced RANDOM ANNUAL inspection to the home. Met with Licensee Rosa Andalon and explained the purpose of the inspection. There were 3 children present. A tour of the home was made both inside and outside. The Licensee uses the day care room, kitchen, dining room and hall bathroom. The regulation fire extinguisher was serviced on 10/03/19. Licensee is reminded to either service or purchase a regulation fire extinguisher every year. The smoke detector and carbon monoxide detector were tested and observed to be operational. The Licensee uses the backyard for the day care and it is totally enclosed by fencing with gates. There is a shaded area and age appropriate toys/equipment. Licensee has a jacuzzi and the lid is locked per regulation requirements. LPA reviewed a sampling of children's records and the children roster. Licensee's Pediatric First Aid/CPR certificates (EMSA approved) are valid through 06/22/21. The last fire drill was done on 12/22/19. Licensee states that there are not any guns/weapons on the property.
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 is reminded that they are responsible for knowing the regulations for a Family Child Care Home and that Licensing information can be accessed online at www.ccld.ca.gov. LPA reviewed and provided Licensee with Guide to Infant Safe Sleep and Effects of Lead Exposure pamphlet (to be provided to all current and future parents).

No deficiencies were cited in areas inspected today. The LIC 9213 (Notice of Site visit) was posted.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Ruth GullTELEPHONE: (805) 895-4073
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2020
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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