426211262-2-5-2020-17-CC-MKST-BLHVYK-20200205155116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426211262
Report Date: 02/05/2020
Date Signed: 02/05/2020 03:51:31 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:	GUTIERREZ FCC AKA CARITAS FELICES DAYCARE		FACILITY NUMBER:	426211262
ADMINISTRATOR:	ANA MARIA GUTIERREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 922-8316
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 6	DATE:	02/05/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:49 PM
MET WITH:	Ana Maria Gutierrez		TIME COMPLETED:	03:55 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	Licensing Program Analyst (LPA), Melissa Stewart, conducted an unannounced annual/random inspection and met with Licensee, Ana Maria Gutierrez and her Assistant who translated this report into Licensee's primary language which is Spanish. The purpose of the inspection was explained and the home was toured inside and out. All required forms are posted in a prominent location. At the time of inspection, there were six (6) children, two (2) being infants. The family child care home operates in the living room, dining area and front porch of the home. LPA observed age appropriate toys, books and furnishings in the indoor activity area. The bathroom used by children was observed to be clean and free of toxins. Three (3) bedrooms and garage are off limits and kept locked during operating hours. All hazardous items are stored inaccessible to children in care. Licensee stated there are no guns or ammunition in the home. Outdoors, LPA observed child sized tables, chairs and shelves for toys. The porch is covered and completely fenced; there are no bodies of water. Combination carbon monoxide and smoke detector was tested and found operational. LPA observed the 2 A10 BC fire extinguisher which was serviced on 5/30/19. Licensee was reminded to service or replace the fire extinguisher yearly. Licensee completes and documents emergency drills. The most recent drill was held on 12/17/19. Licensee and assistant are CPR and first aid certified through 1/24/21. Continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020

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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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: GUTIERREZ FCC AKA CARITAS FELICES DAYCARE	FACILITY NUMBER: 426211262
	VISIT DATE: 02/05/2020

NARRATIVE

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Licensee and assistant have met SB 792 immunization requirement. Assistant completed Mandated Reporter Training per AB 1207 on 8/3/18. A sample of children's records were reviewed and found complete.

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: www.ada.gov/childqanda.htm

LPA reviewed and provided Licensee with Safe to Sleep brochure in English and Spanish. LPA provided “Effects of Lead Exposure” brochure to be distributed to all families. Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home and was advised to review Quarterly Updates and Provider Information Notices (PINs) which can be accessed on-line at www.ccld.ca.gov. LPA assisted Licensee to sign up to receive important updates from Community Care Licensing Division via email.

In the areas evaluated, no deficiency cited.

LPA observed Licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 02/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2020

LIC809 (FAS) - (06/04)

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