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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215932
Report Date: 04/17/2023
Date Signed: 04/17/2023 04:56:45 PM


Document Has Been Signed on 04/17/2023 04:56 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:ZEPEDA FCC AKA ZEPEDA HAPPY KIDS HOME DAYCAREFACILITY NUMBER:
426215932
ADMINISTRATOR:MARISELA ZEPEDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 478-7364
CITY:GUADALUPESTATE: CAZIP CODE:
93434
CAPACITY:14CENSUS: 5DATE:
04/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:39 PM
MET WITH:Marisela ZepedaTIME COMPLETED:
05:05 PM
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On 04/17/23 at 2:30 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced One Year Required Inspection of the Family Child Care Home (FCCH). LPA met with Marisela Zepeda Licensee of the FCCH and explained the purpose of the inspection. LPA notes COVID Pre-screening questions were asked of Licensee prior to the inspection. The Licensee's responses suggest the FCCH is void of COVID positive cases. At the time of the inspection, LPA observed there were five (5) children on site during this inspection. There are two (2) adults that live in the home and both adults have received fingerprint clearance.

LPA, in the company of Licensee toured the interior and exterior of the FCCH. This home is a single-story home consisting of living room, dining room, kitchen, three (3) bedrooms, two (2) bathrooms, garage, and outdoor yard. The FCCH’s living room, one (1) bathroom and outdoor yard are accessible for childcare services. Meanwhile, the kitchen, dining area, and garage are made inaccessible by means of a baby gate. In addition, three (3) bedrooms and one (1) bathroom are made in accessible by means of door safety knobs and baby gate. LPA notes part of the outdoor yard is inaccessible to children in care by means of a secured baby gate.

The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. LPA observed an open face heater in the living room that is secured by means of a small gate. In the kitchen, LPA observed sharps are stored in an elevated cabinet. Medication for the family is stored in an elevated cabinet in the kitchen that is locked. LPA observed cleaning compounds are stored in an elevated cabinet in the kitchen that is locked and in the garage. LPA notes all areas are inaccessible to children in care. The bathroom used for childcare is clean and free of toxins. LPA observed toys, furniture, and equipment in the FCCH are age appropriate and in good condition. LPA notes there are plenty of activities for children indoors and outdoors. CONT 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:
DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/17/2023
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: ZEPEDA FCC AKA ZEPEDA HAPPY KIDS HOME DAYCARE
FACILITY NUMBER: 426215932
VISIT DATE: 04/17/2023
NARRATIVE
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Required forms are predominantly posted on the entrance of the FCCH. LPA observed a combination smoke and carbon monoxide detector in the FCCH. Detector was tested at 4:30 PM and was found to be operable. The FCCH has a regulation fire extinguisher on site which was purchased on 02/23/23. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services. The Licensee informed LPA no firearms or ammunition are stored on site.

LPA and licensee toured the outdoor yard. The outdoor yard is fenced, and all exits are secured. LPA observed part of the outdoor yard is made inaccessible by means of baby gates. LPA observed children yard has plenty of natural shading to afford the children in care. Children have access to filtered water by means of individual water cup that are labeled. LPA observed three (3) sheds that are locked and inaccessible to children in care. LPA observed there are plenty of toys, furniture and equipment that is age appropriate and in good conditions. LPA observed there are no bodies of water on site.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records. LPA reviewed 15-minute sleep logs and found them to be current. A review of the FCCH's fire drill log shows the last drill occurred on 03/20/23. The Licensee's records were reviewed. Licensee’s pediatric CPR and First Aid certification expires on 4/05/2025. Licensee’s Mandated Reporter training certificate expires on 02/20/2024. Assistant’s records were also reviewed and reveals assistant’s pediatric CPR and First Aid certification expires 04/07/2024 and Mandated Reporter training certificate expires 03/29/2024.

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. CONT 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023
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: ZEPEDA FCC AKA ZEPEDA HAPPY KIDS HOME DAYCARE
FACILITY NUMBER: 426215932
VISIT DATE: 04/17/2023
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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.

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 for 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.

A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Marisela Zepeda.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023
LIC809 (FAS) - (06/04)
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