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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566207582
Report Date: 12/20/2023
Date Signed: 12/20/2023 11:32:06 AM


Document Has Been Signed on 12/20/2023 11:32 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:SANDOVAL FAMILY CHILD CAREFACILITY NUMBER:
566207582
ADMINISTRATOR:ESTHER SANDOVALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 794-0716
CITY:VENTURASTATE: CAZIP CODE:
93001
CAPACITY:14CENSUS: 8DATE:
12/20/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Esther SandavolTIME COMPLETED:
11:46 AM
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On 12/20/2023 Licensing Program Analyst (LPAs) German Negrete and Licensing program Analyst Susana Martinez conducted an unannounced Required- 3 year inspection. LPAs arrived at 9:07 AM and met with Licensee Esther Sandoval and her Assistant Maria Huerta and advised Licensee of the purpose for the inspection. Together with the Licensee, LPAs toured the facility inside and outside. At the time of inspection there were 8 children in care . FCCH Hours of operation are from 7:30am to 5pm Monday through Friday.

LPAs observed licensing documents mounted on the wall in the main child care room. Parents rights we're mounted on the wall as well. LPAs Provided a entry check list to Licensee At 09:48 PM LPAs reviewed the sign in/ sign out sheet. LPAs noticed 8 children were sign in by their parents. The FCCH is a two story home the main child care room is on the first floor. The second floor is not utilized for child care and is blocked off by a gate. The FCCH does have a fire place and is blocked off to prevent children from having access. The FCCH did have age appropriate toys and furniture readily accessible for children in care. In the kitchen LPAs observed kives are safely secured. LPAs observed the fire extinguisher. The last service date was 01/23/2023 The licensee did not have the carbon monoxide detector mounted on the wall, LPAs reminded the licensee of the Tittle 22 regulation 1597.543, which states all FCCH need to have a functioning carbon monoxide detector. LPAs informed the Licensee will she will be cited(see 809D).

LPAs continued inspection in the sleeping area. FCCH provides children with individual sleeping mats during
quiet time if they choose to sleep. LPAs observed the mats were clean. The LPAs toured the back yard. The out door play area has an ample amount of space for children to play. LPAs observed the playground has age appropriate toys and structures available for children to use with impact absorbing material laid through out the yard. The playground has ample amount of shade available. Last disaster plan drill was conducted on 12/04/2023.

Continued on 809 C page
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SANDOVAL FAMILY CHILD CARE
FACILITY NUMBER: 566207582
VISIT DATE: 12/20/2023
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The FCCH also had a very organized storage area where all the arts and board game are kept. There are no swimming pools or other bodies of water present. LPAs observed the trash containers had tightly covered lids. Children and staff records were reviewed at 10:05 am. In total there were 5 files being reviewed. LPAs observed children's files to be complete and current. LPAs verified SB792 Child Care Adult Immunization and Tuberculosis requirements. In total LPAs reviewed licensee and the assistants files. Adults present have current Pediatric CPR/First-Aid certificates that are valid until 03/23/2025. The Licensees mandated reported training is current and will expire on 06/25/2025, The assistant mandated reported training is current and expires 6/23/2025. No fire arms and ammunition are located in the home.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

This FCCH does not provide Incidental Medical Services – IMS. Incidental Medical Services (IMS) policy was


discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of
Operation that includes 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) or
(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the
ADA are available at: https://www.ada.gov/resources/child-care-centers/.
Continued on

LPAs 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.

Furthermore to improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its Continued

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SANDOVAL FAMILY CHILD CARE
FACILITY NUMBER: 566207582
VISIT DATE: 12/20/2023
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 and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

During todays visit the Licensee was informed she will be receiving one type B citation and one Technical violation.

During the exit interview, Esther Sandoval, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS today, 12/19/2023.

A notice of site visit was given and must remain posted for 30 days. Appeal rights were given.

Exit interview conducted and report was reviewed with the licensee in Spanish Esther Sandoval.

License was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies throughout California.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4
Document Has Been Signed on 12/20/2023 11:32 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117


FACILITY NAME: SANDOVAL FAMILY CHILD CARE
FACILITY NUMBER: 566207582

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above as a carbon Monoxide Detector was missing. Which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/20/2023
Plan of Correction
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During the inspection Licensee found the Crabon Monoxide Detector and tested the detector at 11:11am. Carbon Monoxide detector was found to be working.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 218-0429
LICENSING EVALUATOR NAME: German NegreteTELEPHONE: 805-315-8362
LICENSING EVALUATOR SIGNATURE:
DATE: 12/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/20/2023
LIC809 (FAS) - (06/04)
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