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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213957
Report Date: 06/13/2022
Date Signed: 06/13/2022 12:44:33 PM

Document Has Been Signed on 06/13/2022 12:44 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:CAC - LITTLE VILLAGE CENTERFACILITY NUMBER:
426213957
ADMINISTRATOR:FRANCISCA OSUNAFACILITY TYPE:
850
ADDRESS:219 W. CHAPELTELEPHONE:
(805) 922-2243
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 7DATE:
06/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Maria RuizTIME COMPLETED:
12:40 PM
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On June 13, 2022 at 9:00 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Site Supervisor, Maria Ruiz LPA explained the purpose of the inspection. Prior to inspection LPA asked screening questions related to COVID -19 and Site Supervisor's responses indicate there are no COVID-19 exposure on site. The CCC operates Monday, to Friday 6:30 AM to 4:30 PM

LPA in the company of Ms. Ruiz toured the Center inside and out. There were 7 day care children and 4 staff present during the inspection. Licensing required forms are posted in the wall. The current snack menu is also posted. The outdoor playground is enclosed with wooden fence. It has age appropriate toys and equipment. The center has drinking water available for children inside and out.

CCC sign in/sign out was reviewed and meets the regulation. A sampling of children and staff records were reviewed. Children's file contains emergency and contact information. Staff qualifications were verified. Teachers present have current Pediatric First Aid/CPR certificates that expire on 8/15/2022. LPA verified SB 792 Child Care Adult Immunization record and tuberculosis requirements. Staff have renewed Mandated Reporter Training per AB 1207 which expires on 8/12/2023. CCC's staff physically checks and documents the napping toddlers. Facility is following current Covid-19 guidelines.

No deficiencies were cited during today's visit.

Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2022
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: CAC - LITTLE VILLAGE CENTER
FACILITY NUMBER: 426213957
VISIT DATE: 06/13/2022
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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 Child Care Centers Sections 101173 and 101226.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.

Site Supervisor was reminded that all adults 18 and over, 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 Child Care Center. 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview was conducted and report was reviewed with the Site Supervisor, Maria Ruiz
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2022
LIC809 (FAS) - (06/04)
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