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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215783
Report Date: 07/24/2020
Date Signed: 07/24/2020 10:47:01 AM

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:PADILLA FCC AKA ANA'S FAMILY CHILD CAREFACILITY NUMBER:
426215783
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 5DATE:
07/24/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ana PadillaTIME COMPLETED:
11:00 AM
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On 07/24/2020, Licensing Program Analyst (LPA) Christian Patterson met with Licensee Ana Padilla and explained the purpose of the visit. Due to COVID-19, a tele-inspection of the facility was completed for an Increase of Capacity inspection. Together the LPA and applicant toured the home inside and outside.

Licensee uses a playroom, back yard, two bedrooms, kitchen, and one bathroom for day-care. The living room, one bedroom, and garage are off limits. Fire-Clearance was granted on 07/06/2020. The 2A10BC regulation fire extinguisher was purchase on 06/15/2020. LPA observed functioning smoke and carbon monoxide detectors in the home. LPA observed gates and locks on the living room, hallway, bedroom and garage making them inaccessible to children in care. There are age appropriate toys and day-care equipment in the home. The fenced back yard has age appropriate toys and day-care equipment. LPA advised applicant must provide visual supervision while the children are playing both inside the home and outside in the backyard. Licensee stated that there are no firearms or ammunition in the facility. LPA did not observe any bodies of water in the home. Preventative Health & Safety and Nutrition Training was completed on 04/13/19. Applicant First Aid/CPR certificates is valid until 04/2021. Applicant AB 1207 Mandated Reporter Training Certificate expires 05/11/21.

LPA discussed and verified SB 792 (Child Care Employee and Volunteer: Immunization and Tuberculosis Requirements). Applicant was informed walkers, bouncers and any similar object that restricts children's movement are prohibited from licensed facilities.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Christian PattersonTELEPHONE: (805) 315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020
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: PADILLA FCC AKA ANA'S FAMILY CHILD CARE
FACILITY NUMBER: 426215783
VISIT DATE: 07/24/2020
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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

Licensee is reminded that they are responsible for knowing the regulations for a Family Child Care Home and that Licensing information can be accessed online at www.ccld.ca.gov. LPA reviewed the handouts "Safe Sleep in Child Care, A Child Care Provider's Guide to Safe Sleep, and the Effects of Lead Exposure".


There were no deficiencies cited today. The LIC 9213 (Notice of Site Visit) was emailed to the Licensee.

The facility is licensed for a capacity of 14 children effective today, 07/24/2020.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Christian PattersonTELEPHONE: (805) 315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020
LIC809 (FAS) - (06/04)
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