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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426210422
Report Date: 06/04/2021
Date Signed: 06/08/2021 06:56:48 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:GONZALEZ FCC AKA LITTLE TIKES CHILD CAREFACILITY NUMBER:
426210422
ADMINISTRATOR:ARMIDA GONZALEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 937-1903
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:14CENSUS: 3DATE:
06/04/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:33 AM
MET WITH:Armida GonzalezTIME COMPLETED:
12:45 PM
NARRATIVE
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On 6/4/2021, at 10:33 AM, Licensing Program Analysts (LPAs) Gigi Reyes and Francisca Velazquez conducted an unannounced Required Annual Inspection of the Gonzalez Family Child Care Home. LPAs met with Licensee Armida Gonzalez and discussed the purpose of the inspection.
Due to COVID-19 pandemic, LPAs asked the pre screening questions prior to inspection. Licensee's responses indicate there was no COVID-19 exposure on site.

LPAs toured the interior and exterior of the home. LPAs observed 3 children who were playing in the converted garage. The home uses living room, dining area, hallway bathroom, converted garage and backyard for day care. The home's second floor is not accessible to children in care with a child safety gate at the bottom of the stair. The bathroom is observed to be clean and free of toxin. Kitchen knives are kept inaccessible to children. At 10:54 AM, carbon monoxide and smoke detectors were tested and found functional. 2A10 BC fire extinguisher was serviced on 1/20/2021.

LPAs observed that there is an above ground spa in the backyard. Spa is situated under a patio surrounded with heavy duty tarp. It was ensured that spa was covered and secured during the time of inspection. Licensee stated that it was installed on or about 3/16/2020, when pandemic started. LPA advised Licensee that prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to installation of in-ground or above-ground swimming pools, spas, or other bodies of water.

Licensee informed LPAs there are no firearms or ammunition on the premises.

Continued on LIC 809 C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021
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 4
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: GONZALEZ FCC AKA LITTLE TIKES CHILD CARE
FACILITY NUMBER: 426210422
VISIT DATE: 06/04/2021
NARRATIVE
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LPA Velazquez reviewed children's file. Review of file revealed that Child # 1, Child # 2 and Child # 3's immunization are not documented and updated at Child's PM 286 as required by the California Code of Regulations, Title 17, Section 6070. FCCH and Licensee's record were also reviewed. CPR expires 1/20/2023, Mandated Reporter Training per AB 1207 expired 7/26/2020. Licensee was advised that Mandated Reporter Training should be renewed every 2 years.

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 reviewed and provided Licensee with the Safe Sleep Regulations and form LIC 9227 Individual Infant Safe Sleeping Plan. LPAs reiterated that crib or play yards shall be free from all loose articles, and sleeping infant (0 -24 months) supervision and documentation every 15 minutes. LPAs provided the web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing.

In the areas evaluated, deficiencies were cited under Title 22 Division 12. Appeal Rights were given to Licensee.

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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: GONZALEZ FCC AKA LITTLE TIKES CHILD CARE
FACILITY NUMBER: 426210422
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/14/2021
Section Cited

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Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:
(3) Installation of in-ground or above-ground swimming pools, spas ....
This requirement is not met as evidenced by:
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During the tour of the home LPAs observed the above ground spa. Licensee stated it was installed over a year ago when pandemic started. Licensee did not inform CCDL and did not submit new facility sketch regarding the installlation of the spa. This poses a potential risk to health and safety of children in care.
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Type B
06/14/2021
Section Cited

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The licensee shall document each child's immunization as required by the California Code of Regulations...
(1) This requirement includes updating each child's PM 286 (6/95)...

This requirement is not met as evidenced by:
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LPAs review of Children's file revealed that Child 1, Child 2 and Child 3's immunization are not updated on child's PM 286. This poses a potential risk to health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 06/04/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/04/2021
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: GONZALEZ FCC AKA LITTLE TIKES CHILD CARE
FACILITY NUMBER: 426210422
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/14/2021
Section Cited

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(b) (1)   On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training...

This requirement is not met as evidenced by
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LPAs review of Licensee's record revealed that Licensee's AB 1207 expired in 7/26/2020.
This poses a potential risk to health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 06/04/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/04/2021
LIC809 (FAS) - (06/04)
Page: 3 of 4