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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215400
Report Date: 10/18/2023
Date Signed: 10/18/2023 11:05:36 AM


Document Has Been Signed on 10/18/2023 11:05 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:VARGAS FAMILY CHILD CAREFACILITY NUMBER:
426215400
ADMINISTRATOR:ROSA MARIA VARGASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 617-6677
CITY:SANTA BARBARASTATE: CAZIP CODE:
93111
CAPACITY:14CENSUS: 10DATE:
10/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Rosa Maria VargasTIME COMPLETED:
11:20 AM
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On October 18, 2023 at 9AM Licensing Program Analyst (LPA) Susana Martinez conducted an unannounced required 1 year inspection. LPA met with Licensee Rosa Maria Vargas and advised her of the purpose for the inspection. Licensee provided LPA a tour of the home inside and outside. LPA observed 9 children in the dinning room along with Licensee's assistant. Rosa denies having guns/ammunition in the home.

The Licensee uses the living room, dining room, fenced backyard hall bathroom and 1 bedroom for the day care. At 9:08 AM while touring the home, LPA observed the bedroom door closed. Licensee opened the door and stated there was a 10-month old infant (C1) inside the bedroom trying to fall asleep. LPA observed C1 to be crying. LPA reminded Licensee that per CCR 102425(j)(5) if an infant sleeping in a separate room than where the Licensee is stationed, the door to the room the infant is sleeping in must remain open at all times. Licensee asked if this was a new regulation, LPA advised Licensee that requirement is in Safe Sleep Regulations. LPA asked if Licensee is aware of Safe Sleep Regulations, Licensee stated yes. LPA observed the bedroom door remain opened.

LPA observed required licensing documents mounted on the wall at the entrance of the home. Fire and earthquake drills are being documented every six months. Last drill was conducted on 5/16/2023. A regulatory fire extinguisher was observed to be mounted on the wall inside the kitchen and was last serviced 11/01/2022. The dual fire and carbon monoxide detector located in the dining room was tested by the Licensee at 9:11 AM and found to be in working condition. The children's restroom was found to be clean and orderly, no hazardous/ toxic items were observed.

The kitchen is off limits, LPA observed a baby gate at the entrance of the kitchen. Children have access to toys that are age-appropriate inside and outside of the home. Back yard play area is enclosed and has plenty of bicycles, scooters, and activities. There are no bodies of water present at the time of inspection.
Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2023
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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426215400
VISIT DATE: 10/18/2023
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LPA reviewed five children files. All children files were current. Licensee and Assistant's CPR/first aid is valid through 12/09/2023. Licensee was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. Licensee and Assistant's Mandated Reporter Certification is valid through 06/2025.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. LPA observed a safe sleep log being documented for 2 out of the 3 infants in care. LPA asked for C2's documentation of 15-minute checks. Licensee states she stopped documenting C2's sleep as he goes to sleep later. LPA reminded Licensee that the 15-minute checks need to be conducted on infants ages 0-24 months. LPA observed last safe sleep check to be documented on 08/31/23.

LPA provided the following resources to the Licensee:


- Safe Sleep- Frequently Asked Questions.
- Copy of Regulations for Title 22, Division 12 Chapter 1 Article 06. Continuing Requirements 102425 Infants Safe Sleep outlining (j)(5)(A).
Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426215400
VISIT DATE: 10/18/2023
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Licensee advised there were no children in care that required 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

During today's inspection 1 Type A deficiency was issued due to violation of CCR 102425(j)(5). Deficinecy can be found on the attached 809-D.

A technical violation was also issued during today's inspection for missing 15-minute documentation for a 20 month old.

LPA Martinez informed Licensee Rosa Vargas that this report dated 10/18/2023 document(s) One Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.



Also, LPA Martinez informed the Licensee Rosa Vargas to provide a copy of this licensing report dated 10/18/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed in Spanish with the licensee Rosa Maria Vargas. Appeal rights were given.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 10/18/2023 11:05 AM - It Cannot Be Edited

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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426215400

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(j)(5)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: If the infant is sleeping in a separate room from where the provider is stationed, the door to the room the infant is sleeping in shall remain open at all times.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above as Licensee admitted she closes the bedroom door when infants are sleeping which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 10/18/2023
Plan of Correction
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Licensee opened the bedroom door and agreed to keep it open while infants are inside sleeping.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2023
LIC809 (FAS) - (06/04)
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