426215980-6-17-2021-17-CC-FVEZ-C43VZM-20210617165258

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215980
Report Date: 06/17/2021
Date Signed: 06/17/2021 04:53:06 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:	CHAVEZ FCC AKA LINDA'S CHILD CARE		FACILITY NUMBER:	426215980
ADMINISTRATOR:	HERLINDA CHAVEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 868-6405
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 4	DATE:	06/17/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:50 PM
MET WITH:	Herlinda Chavez		TIME COMPLETED:	05:00 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 6/17/21 Licensing Program Analyst (LPA) Gigi Reyes and Francisca Velazquez conducted an unannounced Required Inspection of the facility. LPAs meet with Herlinda Chavez, Licensee of the facility and explained the purpose of the inspection. LPAs in the company of the Licensee, toured the interior and exterior of the home. This is a three (3) bedroom, two (2) bathroom home. Licensee stated that living room, kitchen, backyard and hallway bathroom are accessible for child care services, while all three (3) bedrooms are off limits to the children. During the time of the inspection, Licensee was caring for four (4) children. Assistant, Lucia Magana was also present during the inspection. LPAs observed required forms posted in the walls of the living room. LPAs observed a smoke and carbon monoxide detector in the facility. The detector was tested by Licensee (4:15 PM) and found to be operable. The home purchased regulation fire extinguisher on 6/11/21. LPAs reminded Licensee that fire extinguisher needs to be either service or purchase annually. The home maintains working telephone services. LPAs observed all cleaning supplies and toxins are stored in high closet in the hallway that is lock and is inaccessible to the children in care. The facility is orderly, clean and has ventilation for child care services. The restroom used for children was found to be clean and orderly with hand washing posters available for children. Medication in the facility is stored on an elevated shelf in a kitchen cabinet and are inaccessible to children. Toys and equipment observed in the facility are age appropriate. LPAs observe fenced backyard with age appropriate equipment for children. Backyard has a small shed that is always locked and inaccessible to children. Licensee stated that when children play outside she visually supervises all children. LPAs reminded Licensee of the importance of having direct supervision when children are engaged in outside play. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the facility. 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: 06/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 2

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: CHAVEZ FCC AKA LINDA'S CHILD CARE	FACILITY NUMBER: 426215980
	VISIT DATE: 06/17/2021

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
26
27
28
29
30
31
32

A sampling of the children's record were reviewed and found to have current and up to date with emergency information cards. The Licensee's records indicate Mandated Reporter training was completed 7/31/20, and CPR and First Aid certifications expires on 5/6/23. The last emergency drill was conducted in the facility on 6/12/21. LPA's reminded Licensee that emergency drills are required every six (6) months and need to be documented.

The Licensee is not providing 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: www.ada.gov/childqanda.htm

LPAs discussed COVID 19 guidance and best practices with the Licensee. Licensee was reminded that it is Licensee's responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov. LPAs and Licensee discussed safe sleep regulations and LPAs provided a copy of the regulations and LIC 9227 for Licensee to review.

In areas evaluated, there were no citations issued during today's visit.

Report was read to Licensee by LPA Velazquez in Spanish. .

LPA provided Licensee with Notice of Site visit (LIC 9213) which was posted by the Licensee.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 06/17/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2021

LIC809 (FAS) - (06/04)

Page: 2 of 2