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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214052
Report Date: 07/16/2019
Date Signed: 07/16/2019 04:09:56 PM

COMPREHENSIVE INSPECTION
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:AYALA FCC AKA JULIE'S HOME DAY CAREFACILITY NUMBER:
426214052
ADMINISTRATOR:JULIE AYALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 737-3040
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 13DATE:
07/16/2019
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Julie AyalaTIME COMPLETED:
04:15 PM
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A comprehensive required inspection was conducted by Licensing Program Analysts (LPAs) S. Mendoza-Ceja and C. Patterson who met with Licensee Julia Ayala and her assistants. The home was toured inside and outside. Licensee stated there are no firearms/ammunition or bodies of water on the premises. LPAs did not observe any bodies of water. There is a smoke detector and carbon monoxide detector in the home.
There is a 2 A10 BC Fire Extinguisher which is current. Licensee was reminded the fire extinguisher needs to be replaced or serviced yearly. The last fire drill documented is 05/09/2019. LPA reviewed children's records, including the child care roster. LPA reviewed the handouts "A Child Care Provider's Guide to Safe Sleep, Safe Sleep in Child Care, and Effects of Lead Exposure". LPA reviewed current CPR and First Aid for Licensee Julie Ayala, Oscar Ayala, Saima Ayala, and Maria Vargas. LPA reviewed the requirement for care providers/employees and volunteers to obtain immunization against Influenza, Pertussis, and Measles.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

No deficiencies cited. 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) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019
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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