426212122-10-28-2022-17-CC-GRES-CKMRD8-20221028125530

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426212122
Report Date: 10/28/2022
Date Signed: 10/28/2022 12:55:40 PM

Document Has Been Signed on 10/28/2022 12:55 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:	CARDOSO FAMILY CHILD CARE		FACILITY NUMBER:	426212122
ADMINISTRATOR:	BLANCA CARDOSO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 925-5378
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	14	CENSUS: 9	DATE:	10/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Blanca Cardoso		TIME COMPLETED:	01:00 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 October 28, 2022 at 10:15 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Licensee, Blanca Cardoso and Licensee's assitant. LPA asked Covid-19 pre screening questions, licensee's responses indicate there are no COVID-19 exposure on site. Licensee provided LPA a tour of the facility inside and out. There were 9 children present during the inspection 2 of whom are infants, 1 school age child came later. This is 2 story home with 3 bedrooms and 3 1/2 baths. Family Child Care Home (FCCH) uses living room, family room, kitchen, dining, 1 and 1/2 bathrooms and the gated back yard. Garage is set up for day care additional activities. The 2nd floor is not accessible to day care children with a baby gate at the bottom of the stair case making it inaccessible to day care children, LPA observed age appropriate toys, books and furnishings in the indoor activity area. LPA observed pack n play in the napping room. All hazardous items are stored inaccessible to children in care. The backyard is enclosed with a 7 foot vinyl fence. LPA observed age appropriate play equipment and toys in the back yard. Licensee stated there are no guns nor ammunition in the home. No bodies of water was observed. Fire extinguisher was serviced on 1/20/2022. Smoke and carbon monoxide detectors were observed. LPA reviewed facility file, licensee has current Pediatric First Aid and CPR which expires, 9/1/2024. Licensee and Assistant do not have the current Mandated Reporter Training. Staff have proof of immunization per SB 792 against pertussis, and measles. FCCH conducts fire and disaster drill every 6 months, last drill was conducted on 7/12/2022. Children's roster is current. LPA reviewed children records, Emergency and Identification card on file. Infant Safe Sleep Plan (LIC9227) for Infants 0 to 12 months are completed and signed by authorized representative and licensee, licensee and assistant check and document napping infants every 15 minutes. CONTINUED on LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022

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: CARDOSO FAMILY CHILD CARE	FACILITY NUMBER: 426212122
	VISIT DATE: 10/28/2022

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

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.

During today's inspection, deficiency was cited under Title 22 Division 12 and Technical Violation was issued.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Blanca Cardoso and assistant, Marina Cardoso who translated the report in Spanish.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 10/28/2022 12:55 PM - It Cannot Be Edited

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: CARDOSO FAMILY CHILD CARE	FACILITY NUMBER: 426212122
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in Licensee and assistant have no current Mandated Reporter Training certificate on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/07/2022
	Plan of Correction
1 2 3 4	Licensee agreed to renew the Mandated Reporter Training for herself and assistant and submit the plan of correction to Community Care Licensing no later than 11/7/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2022

LIC809 (FAS) - (06/04)

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