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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566200634
Report Date: 09/25/2019
Date Signed: 09/25/2019 11:43:08 AM

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:RUVALCABA FAMILY DAY CARE HOMEFACILITY NUMBER:
566200634
ADMINISTRATOR:MARGARITA RUVALCABAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 486-6549
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 0DATE:
09/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Margarita RuvalcabaTIME COMPLETED:
11:45 AM
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Licensing Program Analyst (LPA) Michael Avila made an unannounced visit for the purpose of conducting a Random Annual Inspection. The purpose of the visit was discussed with the Licensee Margarita Ruvalcaba and together we tour the home inside and outside.

There are no bodies of water on the property. Licensee has no firearms or ammunition the home. Kitchen knives and cleaning products are stored inaccessible to children. Fire extinguisher is a 2A10BC with a service date of 5/18/19 was observed mounted on the wall. The home has a smoke and carbon monoxide detector. Licensee has all required forms posted for parent's to view. The home provides safe toys, play equipment and materials. The children have safe and comfortable accommodation. Licensee's is current with CPR/First Aid with expiration date of 09/23/2020. Licensee keeps proof of SB 792 Adult Immunization's on file. LPA discussed AB1207 Mandated Reporter Training pending Spanish training. LPA reminded Licensee is responsible for being aware of CCR. Div. 12,Title 22 regulations which can be accessed at www.ccld.ca.gov.

Incidental Medical Services (IMS) currently has not children with IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

No deficiencies were cited during today's visit. Visit conducted in Spanish.

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 MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2019
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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