<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566207006
Report Date: 02/03/2022
Date Signed: 02/03/2022 11:29:20 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:AYALA FAMILY CHILD CAREFACILITY NUMBER:
566207006
ADMINISTRATOR:MARIA AYALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 984-7180
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY:14CENSUS: 2DATE:
02/03/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Maria AyalaTIME COMPLETED:
11:40 AM
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 February 3, 2022 at 10:10AM, Licensing Program Analyst (LPA) Betzayra Cervantes made an unannounced visit to conduct a Required - 1 Year Inspection. LPA met with licensee Maria Ayala and explained the purpose of the inspection. Prior to entering the facility, LPA conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA in the company of the Licensee toured the interior and exterior of the facility. There were two children in care at the time of the inspection.

The home is a seven bed, five bath, two story home. All adults in the home are fingerprint cleared. The licensee uses the playroom, back family room, dining area, kitchen, one bathroom and the backyard for day-care. LPA observed a safety gate at the bottom of the stairs leading to the second floor to keep it inaccessible. The second floor is not used for day-care and is off limits to children. The seven bedrooms, four bathrooms, laundry room and garage are off limits. LPA observed a screened fireplace in the back room preventing children from having access. LPA observed age appropriate toys and furnishings available for children in care in good condition and free of hazards. Licensee has a secured fence in the backyard and age appropriate toys for children in care, found in good condition and free of hazards. Licensee states that there are no firearms and ammunition in the home. LPA observed one small dog inside of the home. Licensee reported that the dog's vaccinations are up to date.

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 in care was observed to be clean and sanitary. LPA observed a carbon monoxide and smoke alarm detector which was tested and found to be operable. A regulation 2A10BC fire extinguisher was observed with a service date of 02/03/2022. Licensee is reminded to service or purchase the fire extinguisher yearly.

CONTINUED ON 809-C

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
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: AYALA FAMILY CHILD CARE
FACILITY NUMBER: 566207006
VISIT DATE: 02/03/2022
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
Licensee's CPR and First Aid training is valid until 10/26/2022. AB 1207 Mandated Reporter Training certificate is valid until 07/22/2023. Licensee last completed an emergency disaster drill on 02/01/2022. All required forms including Notification Of Parent's Rights are prominently posted for parent's or authorized representatives to view. A roster of children in care was observed current and complete. A sampling of children records were reviewed and LPA observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

No deficiencies cited during this visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed in Spanish with the licensee, Maria Ayala.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2