426215387-5-24-2019-17-CC-MJIZ-BCGL4D-20190524082521

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215387
Report Date: 05/08/2019
Date Signed: 05/24/2019 08:25:41 AM

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:	HERRERA FCC AKA CHU CHU TRAIN DAYCARE		FACILITY NUMBER:	426215387
ADMINISTRATOR:	NORMA HERRERA/LEGAL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 314-4760
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	14	CENSUS: 7	DATE:	05/08/2019
TYPE OF VISIT:	Case Management - Annual Continuation	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Norma Herrera		TIME COMPLETED:	11:10 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	Licensing Program Analyst(LPA) Martina Jimenez conducted a required comprehensive inspection and met with Norma Herrera, Licensee. LPA informed Licensee the reason for the visit. Upon entering the home LPA observed infant #1 in a car seat with a bottle prompt up being feed. During the visit Licensee removed infant #1 from the car seat and feed the infant in Licensee's arms. LPA observed 2 infants and 5 children in the home, playing with age appropriate toys and games. LPA observed cubbies, tables, chairs, play kitchen and play house. The kitchen area was observed, cabinets and drawers are not locked and were free of toxins and hazardous items. The knives, medications and cleaning products were stored out of children's reach. The bedrooms are off limits to children, licensee placed a gate in the hallway. The upstairs area are off limits to children, the stairs are properly gated at the bottom. The outdoor play area is completely fenced, LPA observed bike area, plastic play structure and shade area. There is a functioning carbon monoxide detector that meets statutory requirements. The smoke alarm was tested and was found operational. The fire extinguisher was serviced August 7, 2018. The home is clean and organized. Licensee is not providing Incidental Medical Services. Incidental Medical Services (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 THIS IS A REQUIRED VISIT - Report Continues on LIC 809 C and LIC D.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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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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: HERRERA FCC AKA CHU CHU TRAIN DAYCARE	FACILITY NUMBER: 426215387
	VISIT DATE: 05/08/2019

NARRATIVE

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Licensee completed the Mandated Reporter Training per AB 1207 on April 5, 2018. Licensee is current with immunization requirements per SB 792. Licensee conducted and documented safety drills, last drill was conducted April 1, 2019. Licensee is current with CPR and First Aid which expires March 16, 2022. Licensee is current with CPR and First Aid which expires March 2019.

Children's records reviewed. All required forms were signed by parents or child's representative. Children's roster was found complete and updated. All required State forms were posted at the main entrance of the home. Licensee stated that there are no guns or ammunition in the home. There are no bodies of water observed in the home. Licensee is not licensed through Foster Care.

LPA provided and informed licensee Guidelines to Safe Sleep and Effects of Lead Exposure per AB 2370. LPA was provided a brochure on Mandated Reporter Training.

The visit and the report was translated in Spanish by LPA Jimenez.

Today, deficiency cited under Title 22 Division 12 Appeal rights given.
Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. LPA observed licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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: HERRERA FCC AKA CHU CHU TRAIN DAYCARE	FACILITY NUMBER: 426215387
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/08/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/09/2019 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met by LPA observed an infant #1 in a car seat with the bottle prompt up being feed. This failure to protect children poses an immediate risk to children in care.	1 2 3 4 5 6 7	Licensee stated she will submit a written statement on how she will prevent this from happening in the future to CCLD by May 9, 2019.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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