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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213709
Report Date: 03/09/2023
Date Signed: 03/09/2023 02:31:59 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 03/09/2023 02:31 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:HERNANDEZ FCC AKA PRECIOUS MOMENTS FCCFACILITY NUMBER:
426213709
ADMINISTRATOR:CLAUDIA HERNANDEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 563-1274
CITY:SANTA BARBARASTATE: CAZIP CODE:
93110
CAPACITY:14CENSUS: 3DATE:
03/09/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:19 PM
MET WITH:Claudia HernadezTIME COMPLETED:
02:45 PM
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On March 9th 2023 at 12:19PM Licensing Program Analyst (LPA) Rosie Breault conducted an unannounced Annual/Random inspection. LPA met with Claudia Hernandez and advised her the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. At the time of the inspection there three (3) children present, husband and mother - all fingerprint cleared. Per licensee, hours of operation are Monday – Friday 7:30AM – 5:00PM
This is a two (2) story condominium, with 3 (three) bedrooms and two (2) bathrooms, kitchen, living room, and outdoor play area. All bedrooms and one (1) bathroom are located upstairs. Children do not have access and stairs are made inaccessible by a gate. Children have access to living room, kitchen, and 1 (one) downstairs bathroom. Kitchen knives are elevated and inaccessible to children. Cleaning supplies and combustibles are stored elevated and inaccessible to children in care. LPA observed a 2A10BC fire extinguisher with service date of 10/13/2022 mounted on the wall in the kitchen readily accessible. Licensee advised to ensure the fire extinguisher is serviced or a new one in purchased every year. The emergency drill was conducted on 11/22/2022. Carbon monoxide and smoke alarm was tested at 12:44PM and was functioning at the time of inspection. LPA observed age-appropriate toys and furniture readily accessible to children in care. The play yard is enclosed with a fence and no bodies of water are present. Licensee stated no firearms or ammunition are present on the property. Licensee stated no incidental medical services are being provided at this time.

LPA observed the facility roster was current. A sampling of children records was reviewed and found to be current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Licensee's Pediatric CPR/First-Aid certificate is current and valid until 11/4/2023. Licensee's Mandated Reporter certificate is current and valid until 8/4/2024. LPA discussed current Safe Sleep requirements.
CONTINUED ON LIC809C
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:
DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/09/2023
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: HERNANDEZ FCC AKA PRECIOUS MOMENTS FCC
FACILITY NUMBER: 426213709
VISIT DATE: 03/09/2023
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home 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.

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.

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.

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 [facility representative] 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.
LPA provided licensee Safe Sleep FAQ’s, Safe Sleep Log and Entrance Checklist.

There were no deficiencies during today's inspection.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023
LIC809 (FAS) - (06/04)
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