426216052-12-30-2021-17-CC-MJIZ-CA7T3T-20211230132253

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216052
Report Date: 12/30/2021
Date Signed: 12/30/2021 01:23:07 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:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	12/30/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	12:39 PM
MET WITH:	Esperanza Vieyra		TIME COMPLETED:	01:37 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	Due to COVID-19 pandemic, LPA asked the pre-screening questions prior to inspection. Licensee's responses indicate there was no COVID-19 exposure on site. On 12/30/21, at 12:39 PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Case Management inspection of the above referenced Family Child Care Home (FCCH) for a change of capacity. LPA met with Esperanza Vieyra, Licensee of the FCCH and explained the nature/purpose of the inspection. During this inspection, LPA and Licensee together toured the an interior and exterior of the FCCH. LPA observed the FCCH's interior and exterior to be free of hazardous materials and/or toxins at the time of the visit, which would pose a danger to the children in care. LPA observed 1 child in care at the time of the inspection. LPA reviewed the Licensee’s First Aid/ CPR certification which expires on 12/4/2022. LPA observed a regulation fire extinguisher which was serviced on 04/21/2021. LPA reviewed the Licensee’s Mandated Reporter Training certificate, which was completed on 05/23/2021. On 12/22/21, the Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 (Small FCCH) to 14 (Large FCCH). The Santa Maria Fire Department granted a fire clearance following an inspection completed at FCCH on 12/23/2021. LPA observed that COVID-19 documents were posted. CONTINUES ON LIC 809C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 12/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2021

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: 12/30/2021

NARRATIVE

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The home meets Title 22 of CCR requirements for a Large Family Child Care license effective today. Effective date of license is today December 30, 2021. LPA provided the Licensee a Notice of Site Visit (LIC 9213) to be posted.

The inspection visit was conducted in Spanish by LPA Jimenez.

THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS. LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina Jimenez	TELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:	DATE: 12/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/30/2021

LIC809 (FAS) - (06/04)

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