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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426212510
Report Date: 01/03/2020
Date Signed: 01/03/2020 02:00:41 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:MARISCAL FAMILY CHILD CAREFACILITY NUMBER:
426212510
ADMINISTRATOR:DOLORES MARISCALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 347-9505
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 6DATE:
01/03/2020
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Dolores MariscalTIME COMPLETED:
02:10 PM
NARRATIVE
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Licensing Program Analyst (LPA) Martina Jimenez conducted an annual inspection and met with Dolores Mariscal, licensee, Margaret T. Avalos, assistant, Regina Mariscal, licensee's daughter and Pedro Mariscal, licensee’s son. LPA observed 7 sleeping in the family room, as well as a jumper/bouncer in the family room. The day care area used is the family room, bedroom, and hallway bathroom. The second story of the home is off limits to day-care children. LPA observed a gate at the bottom of the stairs and walkway making upstairs area, living room, dinning room, and kitchen areas inaccessible to children. LPA observed a Rocker Bassinet in the bedroom. LPA observed age appropriate toys, games, books, tables and chairs. The backyard is completely fenced. LPA observed 1 large dog secured in the backyard. LPA observed age appropriate toy, and bike, tables, chairs, shade area and bike area. There are no bodies of water observed. Licensee stated that there are no guns or ammunition in the home. Licensee is not a licensed foster care home.

Licensee is not providing Incidental Medical Services. 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

THIS REPORT CONTINUES ON LIC 809C and LIC 809D.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 387-5041
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2020
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: MARISCAL FAMILY CHILD CARE
FACILITY NUMBER: 426212510
VISIT DATE: 01/03/2020
NARRATIVE
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Licensee stated she is current with immunization requirements per SB 792. The safety drills were conducted and documented, last drill was conducted December 16, 2019. Licensee was reminded to conduct and document safety drills once every 6 months.The fire extinguisher was serviced December 5, 2018. Pedro Mariscal is current with CPR and First Aid which expires October 19, 2021.

The Mandated Reporter Training required per AB 1207 is currently not available in Spanish. LPA reviewed the handout "A Child Care Provider's Guide to Safe Sleep" and Effects of Lead Exposure. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided on line at www.ccld.ca.gov. The inspection visit was conducted in Spanish and report was translated in Spanish by LPA Jimenez.. Licensee was reminded to check updates in the regulation at www.ccld.ca.gov.

Today, deficiency cited under Title 22 Division 12 Appeal rights given.
Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 387-5041
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2020
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: MARISCAL FAMILY CHILD CARE
FACILITY NUMBER: 426212510
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/03/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/06/2020
Section Cited

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Criminal Record Clearance- All individuals subject to a criminal record review ...prior to working, residing or volunteering in a licensed home...Violation of Section 102370(d) will result in a citation of a deficiency and an immediate assessment of civil penalties...
This requirement is not met as evidenced by:
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Based on LPA review of the criminal record clearances for this facility, Licensee failed to ensure that Margaret T. Avalosl had a criminal record clearance prior to being employed in the home. Both licensee and licensee's assistant confirmed that Margaret T. Avalos is currently employed in the home. This poses an immediate health and safety risk to 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) 387-5041
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 01/03/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/03/2020
LIC809 (FAS) - (06/04)
Page: 3 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: MARISCAL FAMILY CHILD CARE
FACILITY NUMBER: 426212510
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/03/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/10/2020
Section Cited

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Operation of a Family Child Care Home- The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirement is not met as evidenced by:
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Based on LPA observation that fire extinguisher had not been serviced since 12/5/2018. This poses a potential health and safety risk to children in care.
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Type B
01/10/2020
Section Cited

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Operation of a Family Child Care Home- The home shall provide safe toys, play equipment and materials.

Based on LPA observation LPA observed a Rocker Bassinet in the bedroom and and a jumper/bouncer accessible to children in care during day-care hours. This poses a
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potential health and safety risk to 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) 387-5041
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 01/03/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/03/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4