426215176-9-14-2022-17-CC-MBRT-CJ9MVL-20220914095657

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215176
Report Date: 09/14/2022
Date Signed: 09/14/2022 09:57:06 AM

Document Has Been Signed on 09/14/2022 09:57 AM - 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:	ABONCE FAMILY CHILD CARE		FACILITY NUMBER:	426215176
ADMINISTRATOR:	MICAELA ABONCE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 717-1592
CITY:	LOMPOC	STATE: CA	ZIP CODE:	93436
CAPACITY:	14	CENSUS: 8	DATE:	09/14/2022
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Micaela Abonce		TIME COMPLETED:	10:15 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On September 12th, 2022 at 11:30 AM, Licensing Program Analyst (LPA) Rosie Breault conducted an announced inspection for the purpose of performing a change of location. LPA asked licensee Pre-Screening questions related to COVID-19. Licensee responses to the Pre-screening questions suggest no COVID-19 exposure on site. LPA met with licensee Micaela Abonce and with the assistance of a translator, discussed the purpose of the inspection. Licensee currently holds a large family childcare home (FCCH) and requested licensure at a new location (home). LPA and licensee together toured the interior and exterior of the home. All adults (4) living in the home, are fingerprint cleared. Per licensee, the operating hours will be Monday through Friday from 5:30AM – 5:30PM All areas identified on the facility sketch were inspected. This is a single home which consists of three (3) bedrooms, two (2) restrooms, one (1) living room partially divided into two, one (1) office, kitchen, dining room, garage, laundry room, and outdoor play area. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. CONTINUED ON LIC809C

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose Breault	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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: ABONCE FAMILY CHILD CARE	FACILITY NUMBER: 426215176
	VISIT DATE: 09/14/2022

NARRATIVE

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Off limit areas included: All three bedrooms, office (at this time), master bathroom, garage, and laundry room are excluded from childcare services.

Licensee stated that children will have access to: both divided living rooms, one bathroom, dining room, kitchen, and outdoor play area.

There are age appropriate toys and napping equipment on the premises. Knives and medication for the family are stored out children’s reach, inaccessible to children in an elevated cabinet in the kitchen. The outdoor area is completely fenced with a lock secured and no bodies of water present. LPA notes there is ample shade for children.
Per fire inspection on 8/9/2022, the licensee must utilize the entirety of the living room (both rooms) and the dining room (in addition to rooms listed above) to reach capacity of twelve (12) children. LPA inspected the three rooms mandated by Fire Marshal and licensee was complaint. Fire Marshal indicated on report if licensee was to add another room, the capacity can increase to fourteen (14). Licensee stated she would like to utilize the office for additional care and supervision. Written on Fire Marshall report, there was a language barrier between Fire Marshal and licensee at the time of inspection; therefore LPA determined to contact Fire Marshal via email on 9/12/2022 to confirm potential use of office to increase capacity to 14. Until confirmation from Fire Marshal, capacity stands at 12 children at new location of 1013 N. “Z” St. Lompoc, CA 93436. Due to LPA computer malfunction and unable to write report on 9/12/2022, LPA returned to FCCH on September 14th, 2022 to inform and issue approved license (effective 9/12/2022) for 12 children. There were 8 children present and 3 staff at the time of the inspection on 9/14/2022.

CONTINUED ON LIC809C

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose Breault	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

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: ABONCE FAMILY CHILD CARE	FACILITY NUMBER: 426215176
	VISIT DATE: 09/14/2022

NARRATIVE

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The required fire extinguisher 2A10BC was serviced in February 2022. Combination Smoke detector and carbon monoxide detector was tested at 12:00 PM on 9/12/2022 and was functioning at the time of the visit. Per licensee, stated there are no guns and ammunition in the home. First Aid and emergency kits are available. Licensee has current Pediatric First Aid and CPR which expires 10/18/2023.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The home meets Title 22 Division 12 requirements of a large FCCH license. Effective date of Change of Location to 1013 N. “Z” St. Lompoc, CA 93436 will be noted as 9/12/2022.

An exit interview was conducted via Language Link, and report reviewed with licensee and Notice of Site Visit was placed in prominent location prior to LPA departure.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose Breault	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022

LIC809 (FAS) - (06/04)

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