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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215085
Report Date: 05/18/2021
Date Signed: 05/18/2021 03:25:16 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:GUZMAN FCC AKA ERIKA'S DAY CAREFACILITY NUMBER:
426215085
ADMINISTRATOR:ERIKA GUZMAN/LEGALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(815) 213-2869
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 13DATE:
05/18/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:18 PM
MET WITH:Erika GuzmanTIME COMPLETED:
03:30 PM
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Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced annual/required inspection and met with Licensee, Erika Guzman, Pedro Guzman, Assistant, and Yolanda Salcedo, Assistant. There were 13 children present. Home was toured inside and out. LPA observed age appropriate toys and equipment in the home. The backyard is completely fenced. LPA observed age appropriate toys and play structures.
Licensee stated that there are no guns or ammunition in the home. No bodies of water were observed. Licensee stated she does not have a foster care license.

Fire Extinguisher was serviced on 08/13/2021. Toxins and hazardous items are kept inaccessible to children in care. Children's files were reviewed and found complete. Home has current children's roster. Home conducts and documents fire and disaster drill every 6 months. Last drill was conducted on 3/4/2021. Control of Property was reviewed. Landlord Notification and Landlord Permission to increase capacity are on file. CPR and First Aid expires on 4/15/2023. Licensee has complete record of immunization.

Licensing required forms are posted. LPA discussed the Guide to Safe Sleep, Effects of Lead Exposure, U.S. Consumer Safety Products and Equipment Recall. Flyers were provided to Licensee.


THIS REPORT CONTINUES ON LIC 809C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
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: GUZMAN FCC AKA ERIKA'S DAY CARE
FACILITY NUMBER: 426215085
VISIT DATE: 05/18/2021
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Licensee is not providing Incidental Medical Services (IMS). 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

Licensee is reminded that it is Licensee's responsibility to know the regulations for a Family Child Care Home and that Licensing information can be accessed online at www.ccld.ca.gov.



LPA provided a Handout for Reporting Child Abuse and Neglect Training provided on line at www.ccld.ca.gov.

Today, no deficiencies cited under Title 22 Division 12. The visit and report were translated in Spanish by LPA Jimenez. LPA observed licensee post the Notice of Site visit. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

In the areas evaluated, no deficiencies were cited under Title 22 Division 12.

LPA observed Licensee posted the Notice of Site Visit.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2021
LIC809 (FAS) - (06/04)
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