566211148-5-4-2022-17-CC-BCES-CE4P5S-20220504110112

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566211148
Report Date: 05/04/2022
Date Signed: 05/04/2022 11:01:26 AM

Document Has Been Signed on 05/04/2022 11:01 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	ZAVALA'S FAMILY CHILD CARE		FACILITY NUMBER:	566211148
ADMINISTRATOR:	ROCIO ZAVALA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 890-7814
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY:	14	CENSUS: 7	DATE:	05/04/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Rocio Zavala		TIME COMPLETED:	11:15 AM

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On May 4, 2022 at 9:20AM, Licensing Program Analyst (LPA) Betzayra Cervantes made an unannounced visit to conduct a Required - 1 Year inspection. LPA spoke to licensee Rocio Zavala and conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA discussed the nature and purpose of the inspection. Licensee and LPA toured the facility inside and outside. Licensee and her assistant were caring for seven children at the time of the inspection.

The licensee uses the playroom, one restroom, and back yard for the day care. Licensee states that there are no firearms and ammunition in the home. LPA observed a safety gate at the base of the stairs leading to the second floor which is off limits to children in care. LPA did not observe toxins/hazards accessible to children. There are age appropriate toys and furniture readily accessible to children. In the family room, LPA observed a fireplace with a glass screen preventing children from having access. Licensee advised that the main living room is off limits to the children in care and it is secured with a locked door. The back yard is fully enclosed with a fenced wall. Licensee has age appropriate toys and play structures in the back yard in good condition and free of hazards.

The home has working smoke and carbon monoxide detectors. A 2A10BC fire extinguisher was observed mounted in the playroom with a service date of 09/01/2021. Licensee is reminded to service or purchase the fire extinguisher yearly. All adults in the home are fingerprint cleared. LPA observed the home to be orderly. No bodies of water were observed on site. No toxins nor hazards are accessible to children in care. Detergents and cleaning compounds are stored out of reach of children. The bathroom to be used for children in care was observed to be clean and sanitary.

CONTINUED ON 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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: ZAVALA'S FAMILY CHILD CARE	FACILITY NUMBER: 566211148
	VISIT DATE: 05/04/2022

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Licensee's Pediatric CPR and Fist Aid certification expires on 03/15/2024. AB 1207 Mandated Reporter Training certificate expires on 09/21/2023. Licensee last completed an emergency disaster drill on 4/22/2022. 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. A sampling of children records were reviewed and LPA observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

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

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA 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.

CONTINUED ON 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

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: ZAVALA'S FAMILY CHILD CARE	FACILITY NUMBER: 566211148
	VISIT DATE: 05/04/2022

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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, Rocio Zavala.

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 Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 05/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022

LIC809 (FAS) - (06/04)

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