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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216292
Report Date: 04/19/2022
Date Signed: 04/19/2022 04:14:55 PM


Document Has Been Signed on 04/19/2022 04:14 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:ALCANTAR FCC AKA A & R FAMILY CHILD CAREFACILITY NUMBER:
426216292
ADMINISTRATOR:AALIYAH JESSICA ALCANTARFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 363-1573
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:14CENSUS: 0DATE:
04/19/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
03:06 PM
MET WITH:Aaliyah AlcantarTIME COMPLETED:
04:30 PM
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This is a change of location, previous facility number 406216085.

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 4/19/2022, at 2:40PM, Licensing Program Analyst (LPA) Martina Jimenez conducted an announced change of location, Pre-licensing inspection, and a change of capacity from small license (8 children) to large license (14 children). LPA met with Aaliyah Alcantar, Licensee, the purpose of the visit was discussed with the Licensee and together we toured the inside and outside of the home. There were no children in care at the time of the inspection.

Licensee requested a change of location for a large family child care license and a Fire Clearance was granted on 4/11/2022. The home is a three (3) bedroom, three (3) bath, two (2) story home with an attached garage. The licensee will use the living room, kitchen, dining room, bathroom in the hallway, and backyard.

The three (3) bedrooms and two (2) bathrooms upstairs, along with detached garage were observed to be secured with door knob covers and safety gates making the off-limits areas inaccessible to children in care.

LPA observed the kitchen, and attached garage, secured with locks and safety gates making these areas inaccessible to children. CONTINUES 809-C

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/19/2022
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: ALCANTAR FCC AKA A & R FAMILY CHILD CARE
FACILITY NUMBER: 426216292
VISIT DATE: 04/19/2022
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LPA observed that knives are stores in a high cabinet inaccessible to children. LPA observed child size furniture and material for activities. LPA observed the home to be orderly. 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 in care was observed to be clean and sanitary. The back yard is completely fenced and has age appropriate toys and day-care equipment.

There will be two (2) adults living in the home. All adults have been fingerprint cleared.



LPA observed a regulation 2A10BC fire extinguisher in the kitchen a the time of the inspection. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA observed licensee test both smoke and carbon monoxide detectors in the home at 2:54PM and were functioning at the time of the inspection.

No bodies of water were observed. Licensee stated that there are no weapons or ammunition in the home. Licensee stated she does not hold a foster family license. Licensee is current with immunization required per SB 792.

Licensee Pediatric First Aid/CPR certificate is valid until December 12, 2022. Licensee completed the Mandated Reporter Training on April 9, 2021, that is required per AB 1207. Control of property was verified via review of rental Lease.

LPA discussed Incidental Medical Services with the licensee. Incidental Medical Services (IMS) policy was discussed. When any IMS is provided, a Plan for Providing IMS must be submitted to the

CONTINUES ON LIC 809-C

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
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: ALCANTAR FCC AKA A & R FAMILY CHILD CARE
FACILITY NUMBER: 426216292
VISIT DATE: 04/19/2022
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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: htttp://www.ada.gov/childqanda.htm

LPA reviewed and provided the handout "A Child Care Provider's Guide to Safe Sleep" (PIN 20-24-CCP), Effects of Lead Exposure, What is Carbon Monoxide, and Self- Assessment. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided online at www.ccld.ca.gov.



The home will be licensed once licensee submits verification of the following:

1. Receipt for fire extinguisher

No deficiencies cited during this visit. 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: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 04/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3