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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426210326
Report Date: 07/05/2022
Date Signed: 07/05/2022 02:30:56 PM


Document Has Been Signed on 07/05/2022 02:30 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:BARBOSA FCC AKA HOME SWEET HOME DAYCAREFACILITY NUMBER:
426210326
ADMINISTRATOR:JENIFER BARBOSAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 736-8441
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 3DATE:
07/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Jenifer BarbosaTIME COMPLETED:
02:35 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 7/5/2022 at 12:35 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required inspection and met with Licensee, Ms. Jenifer Barbosa. LPA asked pre screening questions related to COVID- 19 and licensee’s responses indicate there are no COVID -19 exposures on site. LPA discussed the purpose of the inspection with the Licensee. There were 3 children present during the inspection.

LPA and Licensee toured the interior and exterior of the day care. This is two-story home composed of 4 bedrooms and 3 baths, The second floor is off limits with a baby gate at the bottom of the stair case making it inaccessible to day care children. FCCH uses the living room, family room, dining area, kitchen and backyard for day care. LPA observed smoke and carbon monoxide detectors in the home. LPA observed the home to be clean and in order, bathroom is free of toxin. The regulation fire extinguisher was serviced on 8/18/2021. Home conducts and documents fire and disaster drill every 6 months, last drill was conducted on 1/10/2022. The backyard is enclosed by wooden fence and a retainer brick wall. LPA observed age appropriate toys and play equipment. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the home.

LPA Reyes reviewed facility file, Pediatric CPR and First Aid expires on 6/19/2023. Licensee and assistant have proof of immunization on file. FCCH has current roster of children in care. Licensee and assistant renewed the Mandated Reporter Training certificate which expires on 6/14/2023. The children's records were reviewed and found complete. Licensee checks and documents napping infants every 15 minutes.

During today's inspection, no deficiency was cited.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 07/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/05/2022
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: BARBOSA FCC AKA HOME SWEET HOME DAYCARE
FACILITY NUMBER: 426210326
VISIT DATE: 07/05/2022
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
FCCH is not providing Incidental Medical Services (IMS). 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.ht

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Ms. Jenifer Barbosa
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 07/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/05/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2