566209396-4-24-2024-17-CC-LVIA-D4MUST-20240424155051

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566209396
Report Date: 04/24/2024
Date Signed: 04/24/2024 03:51:02 PM

Document Has Been Signed on 04/24/2024 03:51 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:	CONTRERAS FAMILY CHILD CARE		FACILITY NUMBER:	566209396
ADMINISTRATOR:	MARTHA CONTRERAS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 486-9653
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	14	CENSUS: 3	DATE:	04/24/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Martha Contreras		TIME COMPLETED:	04:15 PM

NARRATIVE

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On April 24, 2024 at 2:10 PM, Licensing Program Analyst (LPA) Laura Villanueva made an unannounced visit to conduct a Required - 3 Year Inspection. LPA met with licensee, Martha Contreras and explained the purpose of the inspection. LPA and licensee toured the interior and exterior of the home. Licensee and Assistant were caring for 3 children at the time of the inspection.

The home is a 4 -bedroom, 3- bath 1- story home. The licensee uses the living room, dining area, playroom, kitchen, 1-bedroom, hall bathroom and the back and front yard for childcare. Licensee has a secured fence in the back and front yard. The 3-bedrooms, 2-bathrooms, and garage are off limits and are inaccessible to children in care. The home was organized and free of hazards. LPA observed a screened fireplace in the living room making it inaccessible to children in care. LPA observed age appropriate toys, teaching materials, and furnishings available for children in care in good condition and free of hazards. A regulation 2A10BC fire extinguisher was observed mounted in the playroom with a service date of 04/24/2024. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee states that there are no firearms and ammunition in the home.

No bodies of water were observed on site. Detergents and cleaning compounds are stored in the locked master bedroom keeping items out of reach of children. The bathroom to be used for children in care was observed to be clean. LPA observed a carbon monoxide detector mounted in the hallway and smoke alarm detector in the playroom. .

Licensee's Pediatric First Aid/CPR certificate is valid until 05/07/2024. AB 1207 Mandated Reporter Training certificate is valid until 08/02/25. Licensee last completed an emergency disaster drill on 04/24/2024. 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 LPA observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

CONTINUED ON 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 566209396
	VISIT DATE: 04/24/2024

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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 LIC809C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CONTRERAS FAMILY CHILD CARE	FACILITY NUMBER: 566209396
	VISIT DATE: 04/24/2024

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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.

During the exit interview, Martha Contreras, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

No deficiencies cited today. 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, Martha Contreras.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2024

LIC809 (FAS) - (06/04)

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