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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215563
Report Date: 08/12/2024
Date Signed: 08/12/2024 11:49:27 AM

Document Has Been Signed on 08/12/2024 11:49 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:AMBROSE FAMILY CHILD CAREFACILITY NUMBER:
426215563
ADMINISTRATOR/
DIRECTOR:		MARIBEL AMBROSEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(928) 488-2251
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
08/12/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Maribel AmbroseTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 8/12/24, at 9:35 AM, Licensing Program Analysts (LPAs) Elvin Baddley and Matthew Sapien conducted an unannounced 3 Year Required Inspection of the abovementioned Family Child Care Home (FCCH). LPAs met with Maribel Ambrose, Licensee of the FCCH, and explained the purpose of the inspection. It should be noted Licensee's Assistant, Lucia Vargas-Ambrose, assisted with communication between the Licensee and LPAs as the Licensee is primarily Spanish speaking. LPAs, in the company of the Assistant and Licensee, toured the exterior and interior of the FCCH. The FCCH's living room, bathroom, backyard and front drive are used for child care, while the remainder of the FCCH is excluded from care. At the time of the inspection, LPAs observed ten children present along with two Assistants (cleared and associated) providing care and supervision.

The FCCH is orderly and void of hazardous items. Required forms are posted on the FCCH's wall near the main entry door. Cleaning compounds, medication and sharps are located in elevated locations in the FCCH's kitchen which are inaccessible to children in care. The FCCH has no fireplace but does have a wall heater which is screened. LPAs observed smoke and carbon monoxide detectors in the FCCH. The aforementioned were tested at 10:09 AM and found to be operable. The FCCH has a regulation fire extinguisher which was service 4/23/24. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The bathroom used by children in care is clean and free of toxins. Toys, furniture and play equipment observed in the FCCH are age appropriate. The home maintains working telephone services.

The backyard of the FCCH is enclosed by wooden fencing. The footing in the area is varied. Toys and play equipment observed in backyard area are age appropriate. The backyard is partitioned to separate an area used by dogs from an area used by children. It should be noted two dogs are on site. The Licensee also uses the front drive area for outdoor activities with children. The area is not enclosed. LPAs reminded Licensee to ensure direct supervision of the children when the children are engaged in outdoor activities. LPA observed no bodies of water on site.
(CONT. LIC 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/12/2024
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 3
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: AMBROSE FAMILY CHILD CARE
FACILITY NUMBER: 426215563
VISIT DATE: 08/12/2024
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LPAs reviewed the a sampling of children's records. Children's records were current, complete and possessed emergency contact information and immunization records, among other required licensing documents. The Licensee's records are current and complete with Pedantic CPR and First Aid certifications (EMSA approved) expiring on 4/30/25, and Mandated Reporter training certification expires on 1/9/26. The Licensee informed LPAs no firearm or ammunition are stored on site. As noted, the FCCH has dogs on site. LPAs reviewed vaccination records for each of the dogs and the vaccinations are current.

The Licensee does not provide Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see PIN 22-02CCP. 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) or (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.

LPAs 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.

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, 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.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS on 8/12/24.
(CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: AMBROSE FAMILY CHILD CARE
FACILITY NUMBER: 426215563
VISIT DATE: 08/12/2024
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A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Maribel Ambrose.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024
LIC809 (FAS) - (06/04)
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