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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209237
Report Date: 01/10/2024
Date Signed: 01/10/2024 03:50:59 PM


Document Has Been Signed on 01/10/2024 03:50 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:CENTENO FAMILY CHILD CAREFACILITY NUMBER:
566209237
ADMINISTRATOR:MARTHA CENTENOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 240-7681
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 4DATE:
01/10/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Martha CentenoTIME COMPLETED:
04:20 PM
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On January 10, 2024 2;15 PM Licensing Program Analysts(LPA)s Laura Villanueva and Veronica Diaz made an unannounced visit to conduct a Required - 3 Year Inspection. LPAs met with licensee, Martha Centeno and explained the purpose of the inspection. LPAs and licensee toured the interior and exterior of the home. Licensee and husband (assistant) was caring for 4 child at the time of the inspection.

The home is a 4 -bedroom, 2- bath 1- story home. The licensee uses the playroom, living room, dining area, kitchen, one bathroom and the backyard for childcare. The 3- bedrooms, 1- bathroom, and garage are off limits and are inaccessible to children in care. LPAs observed a screened fireplace in the living room making it inaccessible to children in care. LPAs observed age appropriate toys, teaching materials, and furnishings available for children in care in good condition and free of hazards. Licensee has a secured fence in the backyard. All adults in the home are fingerprint cleared. LPAs did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher was observed mounted by the front door with a service date of 03/13/2023. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee states that there are no firearms and ammunition in the home. Licensee has 2 outdoor dogs on the side of the yard. Dogs have current immunizations.

LPAs observed the home to be orderly. LPAs observed a small fountain in the front yard and a counter top fountain in the bathroom. LPAs advised that fountains with water are not permitted. Licensee immediately removed the fountains in the presence of LPAs..Detergents and cleaning compounds are stored in the garage. The bathroom to be used for children in care was observed to be clean and sanitary. LPAs observed a carbon monoxide and smoke alarm detector in the hallway. .

Licensee's Pediatric First Aid/CPR certificate is valid until 02/10/2025. AB 1207 Mandated Reporter Training certificate is valid until 01/04/2064. Licensee last completed an emergency disaster drill on 08/08/2023. 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. All children records were reviewed, and LPAs observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

CONTINUED ON 809-C

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:
DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/10/2024
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 3


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: CENTENO FAMILY CHILD CARE
FACILITY NUMBER: 566209237
VISIT DATE: 01/10/2024
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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
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, 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 licensed Family Child Care Home. 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.



Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-
CCP. 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: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee [or facility representative] and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/
safe-sleep as an additional resource. LPA also informed licensee [or facility
representative] 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.



CONTINUED ON 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: CENTENO FAMILY CHILD CARE
FACILITY NUMBER: 566209237
VISIT DATE: 01/10/2024
NARRATIVE
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Licensee 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 (R&Rs) throughout California. On this date, 01/10/2024 the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under
California's Megan's Law. No registered sex offenders were found at the facility addresses.
Under state law, some registered sex offenders are not subject to public disclosure; therefore,
they may not have been included in this search. However, the Department conducts a monthly
cross reference of each address on record for all registered sex offenders against all CCLD
facility addresses pursuant to information shared by California DOJ.

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

Exit interview conducted and report was reviewed with the licensee, Martha Centeno.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2024
LIC809 (FAS) - (06/04)
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