426215783-6-2-2022-17-CC-FVEZ-CEZRRH-20220602131509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215783
Report Date: 06/02/2022
Date Signed: 06/02/2022 01:15:16 PM

Document Has Been Signed on 06/02/2022 01:15 PM - 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:	PADILLA FCC AKA ANA'S FAMILY CHILD CARE		FACILITY NUMBER:	426215783
ADMINISTRATOR:	ANA PADILLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 363-1664
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 3	DATE:	06/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Ana Padilla		TIME COMPLETED:	01:14 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 06/02/22, at 10:30 AM Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Ana Padilla, Licensee of the FCCH and explained the nature and purpose of the inspection. Prior to entering the FCCH, LPA conducted COVID-19 pre-screening questionnaire and based on Licensee's responses it was determined that the home is safe and free of any COVID-19 exposures. LPA notes three (3) children are on site along with Co-Licensee, Greg Padilla. LPA, in the company of the Licensee, toured the exterior and interior of the FCCH. The home’s daycare room, kitchen and dining area, bathroom, one (1) bedroom and outdoor yard are used for child care services, while two (2) bedrooms, one (1) bathroom, formal living room, laundry room and additional accessory dwelling unit (ADU) are excluded from services. LPA notes that all bedroom doors were closed and had an additional lock to make the rooms inaccessible. LPA notes that there is no documentation on file regarding the additional accessory dwelling unit. Licensee stated that this information was provided the department when facility applied for a large FCCH license. LPA requested updated facility sketch to include the additional accessory dwelling unit. LPA inspected the additional accessory dwelling unit and notes that this area is off-limits to the children in care. The FCCH is orderly and has ventilation to afford for the children’s comfort and safety. Medication in the FCCH is stored in an elevated cabinet in the hallway of the facility. Sharps are stored in an elevated cabinet in the kitchen. Cleaning compounds were observed to be stored in an elevated closet in the hallway of the facility, in the kitchen on top of two (2) refrigerators, and in the laundry room. All areas are inaccessible to children in care. Toys, furniture and equipment observed in the FCCH are age appropriate. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

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: 06/02/2022

NARRATIVE

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Required forms are posted on the FCCH living room wall. The FCCH has smoke and carbon monoxide detectors which were tested at 11:40 am and found to be operable. The FCCH has a regulation fire extinguisher which was purchased on 4/6/22. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill documentation. The last drill was completed on 5/10/22.

The outdoor play yard is completed fenced. LPA notes that the side yard is fenced off and inaccessible to children in care. LPA notes that the yard affords plenty of shade for the children. Filtered water is accessible to children at all times by means of individual water bottles. Toys, furniture and equipment observed in the yard are age appropriate. LPA observed no bodies of water on site.

A sampling of the children's records were reviewed. The records are current, complete and possessed emergency contact information. The Licensee's records were also reviewed and found to be complete. Licensee’s Pediatric CPR and First (EMSA approved) expires 4/19/23 and Mandated Reporter certificate expires on 8/18/23. LPA reviewed Co-Licensee's records and found them to be current. Co-Licensee's Pediatric CPR and First (EMSA approved) expires 4/13/24 and Mandated Reporter certificate expires on 5/26/24. Both Licensee's had TB and immunization records available for review.

The Licensee notes no firearms or ammunition are stored on site.

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 was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

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: 06/02/2022

NARRATIVE

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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 [facility representative] 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview and report was reviewed with the licensee, Ana Padilla. This inspection and review of report was conducted in Spanish due to Spanish being the primary language of the licensee.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2022

LIC809 (FAS) - (06/04)

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