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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215910
Report Date: 04/17/2020
Date Signed: 05/06/2020 12:44:34 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:GARNICA FAMILY CHILD CAREFACILITY NUMBER:
426215910
ADMINISTRATOR:LETICIA GARNICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 332-1006
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 0DATE:
04/17/2020
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Leticia GarnicaTIME COMPLETED:
01:30 PM
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On 4//17/2020 @12:00 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted pre licensing tele-inspection and had a video conference with the applicant, Leticia Garnica. LPA conducted a virtual tour of the home. This is one story home composed of three bedrooms and 1 bathroom. Living room is the designated day care area. Kitchen and dining room are accessible to day care children. Bedrooms and garage are not accessible to day care children. Applicant stated there are no fire arms nor ammunition in the home.

During the virtual tour, LPA observed licensing forms are posted, Fire extinguisher meets the State Fire Marshall standards which was purchased on 1/21/2020. Carbon monoxide and smoke detector were tested and found functional. All hazardous items such as cleaning products, toxins laundry detergent are stored inaccessible to day care children. LPA observed safe and age appropriate toys. The backyard is appropriately fenced, clean and in order. Applicant stated there are no bodies of water.

Applicant has records immunization, MMR, TDAP and flu shots. Adult and Pediatric CPR and First Aid expires 5/26/2021. Preventative Health Training was completed on 4/13/2019. The control of property was verified. LPA discussed the Pre Licensing packet, Safe sleep Best Practices and Effects of Lead Exposure, fliers will be provided to parents of day care children. Applicant was advised to visit ccld.ca.gov for quarterly updates and Provider's Information Notices.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2020
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: GARNICA FAMILY CHILD CARE
FACILITY NUMBER: 426215910
VISIT DATE: 04/17/2020
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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

Fire Safety Clearance was granted on 3/31/2020

Issuance of License for a Large Family Child Care Home is pending subject for further review.

A tele - inspection was conducted via face time due to COVID-19 pandemic. Pre Licensing Packet was mailed to the applicant.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2020
LIC809 (FAS) - (06/04)
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