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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566209396
Report Date: 10/10/2019
Date Signed: 10/10/2019 03:33:06 PM

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:CONTRERAS FAMILY CHILD CAREFACILITY NUMBER:
566209396
ADMINISTRATOR:MARTHA CONTRERASFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 486-9653
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:14CENSUS: 8DATE:
10/10/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:35 PM
MET WITH:Martha ContretrasTIME COMPLETED:
03:50 PM
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Licensing Program Analysts (LPA's) Betzayra Cervantes and Michael Avila made an unannounced visit for the purpose of conducting an Annual Random facility inspection. LPA's met with Licensee Martha Contreras and discussed the nature and purpose of the visit. A tour of the facility was conducted together with LPA's and Licensee both inside and outside.

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 03/14/2019. A smoke and carbon monoxide detector were observed on the wall. No toxins nor hazards were observed accessible to children. The backyard is fully enclosed with a gated fence. No bodies of water were observed on the property. A roster of children in care was observed current and complete. Last emergency drill was conducted on 10/01/2019.

A sample of children's files were reviewed and found to be complete. Licensee's CPR/First-Aid is current until 10/01/2021. LPA's illustrated the Community Care Licensing Website to Licensee to include viewing the Safe Sleep video (in Spanish). LPA's discussed AB1207 Mandated Reporter Training and reminded Licensee it is her responsibility to be aware of all child care regulations which can be accessed at www.ccld.ca.gov.

Incidental Medical Services (IMS) currently has no 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. This inspection was 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) 562-0411
LICENSING EVALUATOR NAME: Betzayra CervantesTELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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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