426215705-10-9-2020-17-CC-SMCA-BU92UQ-20201009174243

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215705
Report Date: 10/09/2020
Date Signed: 10/09/2020 05:42:55 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:	MACIAS FAMILY CHILD CARE		FACILITY NUMBER:	426215705
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	10/09/2020
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Liliana Macias		TIME COMPLETED:	03:30 PM

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 10/9/2020 at 2:30 PM, Licensing Program Analyst (LPA) S. Mendoza-Ceja met with Liliana Macias for the purpose of conducting Case Management Inspection for an increase of capacity to provide care for up to 12/14 children. LPA advised due to COVID-19 State of Emergency and following the Department of Public Health (DPH) guidelines of social distancing a virtual inspection would be conducted. LPA S. Mendoza-Ceja confirmed with Licensee Liliana Macias that she has video capabilities with her cell phone using Facetime to conduct the tele-inspection. Licensee Macias was observed to be providing care to six napping children. Licensee Macias escorted LPA through the entire home, including the backyard. The day care children have access to the living room, dinning area, restroom, garage, and backyard. Licensee only uses bedroom #3 as a walkway to an alternate activity area in the garage. The off limit areas are the bedrooms #1, #2 that have been made inaccessible with plastic door knob covers on the doors. A baby gate is placed at the entrance to the kitchen which will make the kitchen off limits to day care children. Ms. Macias was reminded if the plastic door knob covers or latches become ineffective, it is her responsibility to make the areas inaccessible to the day care children. Licensee stated the smoke and carbon monoxide detector are functional. The fire extinguisher was purchase on 03/09/2020. Licensee stated there are no firearms, ammunition or bodies of water on the premises. LPA did not observe any bodies of water. The child care roster was reviewed. LPA reviewed and provided handouts “A Child Care Provider’s Guide to Safe to Sleep, Safe

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja	TELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020

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: MACIAS FAMILY CHILD CARE	FACILITY NUMBER: 426215705
	VISIT DATE: 10/09/2020

NARRATIVE

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Sleep in Child Care, Safe Sleep Environment, PIN 20-24 Safe Sleep for Infants, and Effects of Lead Exposure. LPA reviewed the requirements for completion of the AB 1207 Child Abuse Mandated Reporter Training verification was reviewed for Licensee and her assistant. LPA reminded, Licensee she is required to complete the Child Abuse Mandated Reporter Training every two years. The last emergency drill was conducted on 08/13/2020. Licensee's Pediatric CPR and First Aid is current (expires 03/24/2020).

LPA reviewed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, and Measles. LPA also advised, each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year or obtain a sign statement declining the influenza vaccination. Verification was reviewed for licensee and her assistant.

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

Fire Clearance was granted on 10/5/2020. Licensure effective 10/09/2020
No deficiencies were observed at the inspection.

Exit interview was conducted with Liliana Macias, via tele-inspection. This report along with a copy of the Notice of Site Visit will be sent to the via email with a read receipt or confirmation of receipt of email, which will act as the Applicants signature. Applicant must sign and return a copy of this pre-licensing report.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja	TELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020

LIC809 (FAS) - (06/04)

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