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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566208939
Report Date: 04/22/2019
Date Signed: 04/22/2019 11:30:22 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:
566208939
ADMINISTRATOR:PAULA AYALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 844-0573
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 6DATE:
04/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Paula AyalaTIME COMPLETED:
11:30 AM
NARRATIVE
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Licensing Program Analyst (LPA) Michael Avila made an unannounced visit for the purpose of conducting an Annual Random facility inspection. LPA Avila met with Licensee Paula Ayala and discussed the nature and purpose of the visit. A tour of the facility was conducted with Licensee. Licensee states there are no firearms stored on the property. A 2A10BC fire extinguisher was observed mounted on the wall with a service tag dated 9/15/18. A smoke and carbon monoxide detector were observed on the wall. No toxins nor hazards were observed accessible to children. Licensee has a small dog in the back yard with is licensed and vaccinated. LPA reminded Licensee she is responsible to provide care and supervision at all times when children are in care to include when the children are playing with pets at the facility. The backyard is fully enclosed with a gated fence. No bodies of water were observed on the property. Children's records were reviewed. Licensee's CPR/First-Aid is current until 9/5/19. LPA Avila illustrated the Community Care Licensing Website to Licensee and reminded Licensee it is her responsibility to be aware of all child care regulations which can be accessed at www.ccld.ca.gov.

Licensee denies taking care of any children who require incidental medical services. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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)/ (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 issued during this facility inspection.

This inspection was conducted in Spanish.
SUPERVISOR'S NAME: Patricia S. GutierrezTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 04/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2019
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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