426216052-11-2-2020-17-CC-BCES-BUZ25H-20201102160535

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216052
Report Date: 11/02/2020
Date Signed: 11/02/2020 04:06:11 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:	VIEYRA FAMILY CHILD CARE		FACILITY NUMBER:	426216052
ADMINISTRATOR:	ESPERANZA VIEYRA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 264-8289
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY:	14	CENSUS: 0	DATE:	11/02/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Esperanza Vieyra		TIME COMPLETED:	04:10 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	This is a change of location, previous facility number 426210472. On November 2, 2020 at 2:30pm, Licensing Program Analyst (LPA) Betzayra Cervantes conducted an announced change of location Pre-licensing inspection. Due to the COVID-19 and Department of Public Health guidelines of social distancing, a tele-inspection was conducted. LPA conducted the tele-inspection via FaceTime and met with Licensee Esperanza Vieyra. LPA discussed the nature and purpose of the inspection. During this tele-inspection the licensee took LPA on a tour of the facility. There were no children in care at the time of the inspection. Licensee initially requested a change of location for a large family child care license, but was denied by the Santa Maria Fire Department on 10/28/2020. Licensee has agreed to operate as a Small Family Child Care Home and was advised that a new change of capacity application must be completed if she wishes to operate as a large. The home is located at the rear of the property and has its own separate address. The home is a two bedroom, one bath single story home. The applicant will use the living room and one bathroom for day-care. The two bedrooms and garage will be off limits and are inaccessible to children in care. Applicant states that she will be taking children to a nearby park area for outdoor activities once social distancing restrictions have been lifted. All adults in the home are fingerprint cleared. LPA did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher was observed mounted against the wall in the locked garage with a service date of 3/10/2020. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed licensee test the combined smoke and carbon monoxide detectors in the home. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020

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: VIEYRA FAMILY CHILD CARE	FACILITY NUMBER: 426216052
	VISIT DATE: 11/02/2020

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LPA observed the home to be orderly. No bodies of water were observed on site. No toxins nor hazards are accessible to children in care. Detergents and cleaning compounds are stored out of reach of children. The bathroom to be used for children care was observed to be clean and sanitary.

Licensee's Pediatric First Aid/CPR certificate is valid until 12/27/2020. Licensee provided a lease agreement to verify control of property. Applicant states that there are no firearms and ammunition in the home.

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.html

No deficiencies cited during this visit. License to operate a Small Family Child Care facility is effective today 11/02/2020. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

Exit interview was conducted with licensee Esperanza Vierya via FaceTime. A copy of this report was reviewed and provided to the licensee. Applicant agreed to receive a copy of report via email and voiced understanding that the read receipt confirmation from email will be in lieu of her signature once she received the report.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2020

LIC809 (FAS) - (06/04)

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