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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215015
Report Date: 08/02/2021
Date Signed: 08/03/2021 07:18:18 PM

Document Has Been Signed on 08/03/2021 07:18 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:PONCE FAMILY CHILD CAREFACILITY NUMBER:
426215015
ADMINISTRATOR:GUADALUPE PONCEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 739-0595
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
08/02/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:03 PM
MET WITH:Guadalupe PonceTIME COMPLETED:
04:10 PM
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On 8/2/21, at 2:03 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted a Required Inspection of the facility. Prior to entering the facility, LPA completed COVID-19 pre-screening questionnaire with Licensee and based on Licensee's responses it was determined that facility did not have COVID-19 exposures. LPA met with Guadalupe Ponce, Licensee of the facility and explained the purpose of the inspection. LPA, in the company of the Licensee, toured the interior and exterior of the facility. This home consists of four (4) bedrooms, four (4) bathroom, living room, kitchen, garage and backyard. Licensee stated that children have access to the living room, dining area, two (2) bathrooms and backyard while all bedrooms and garage are completely off limits to children with safety latches on the doors. At the time of the inspection eleven (11) children are present along with Assistant, Maria Teresa Calderon.

The home was orderly and clean with proper ventilation for all children in care. The bathrooms used for care was clean and free of toxins with hand washing poster for the children. LPA observed a fire place in the living room that is covered and made inaccessible to children. LPA observed kitchen sink has a built in soap dispenser that is inaccessible to children in care. Cleaning compounds are also stored the garage which is locked and inaccessible to children in care. Licensee stated that household medications are stored in the facility bedrooms that are inaccessible to children in care. Toys, furniture and equipment in the facility are age appropriate.

LPA observed required licensing forms and documents post on the wall of the living room in the facility. LPA observed smoke detector and carbon monoxide detector located on the ceiling of the living room. Both smoke detectors were not tested due to children napping in the facility. LPA observed that both detectors had blinking green light, indicating that both detector were operating correctly. Licensee stated that batteries were changed two (2) months ago.LPA observed a regulation fire extinguisher that was serviced 7/2/2021. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log. The most recent fire drill conducted and documented on 7/21/2021. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/02/2021
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: PONCE FAMILY CHILD CARE
FACILITY NUMBER: 426215015
VISIT DATE: 08/02/2021
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LPA observed that the backyard is completely fenced and offers plenty of shade for the children in care. Licensee stated that they spend most of the day outdoors. LPA observed plenty of gross motor activities and identified learning areas for children in care. Toys and play equipment observed in backyard are age appropriate and in good conditions . LPA observed a locked shed in the backyard that is used for storage. LPA also observed another shed that is used by Licensee’s spouse to store gardening supplies and chemicals. LPA observed a gate making Spouse’s shed inaccessible to children. LPA also observed that the shed itself was locked during inspection. LPA observed no bodies of water on site.

Licensee informed LPA no firearms or ammunition are stored on site.

LPA reviewed a sampling of the children records. All records reviewed are current and contains complete emergency card information. Facilities current roster of children was reviewed by the LPA during inspection. All children present during the inspection are noted in the roster. LPA reviewed the Licensee's Pediatric CPR and First Aid certifications which expires 12/21/21 and Mandated Reporter training expiring on 5/15/22.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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: www.ada.gov/childqanda.htm

LPA discussed COVID 19 guidance and best practices with the Licensee. LPA discussed safe sleep regulations with the Licensee. Licensee stated that she is aware of the new safe sleep regulations and has attended a training offered by the local resource and referral office. Licensee was reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2021
LIC809 (FAS) - (06/04)
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