566211203-6-24-2021-17-CC-LVIA-C4AVHW-20210624162746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566211203
Report Date: 06/24/2021
Date Signed: 06/24/2021 04:27:52 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:	MULLER FAMILY CHILD CARE		FACILITY NUMBER:	566211203
ADMINISTRATOR:	SUSANA MULLER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 382-1739
CITY:	OXNARD	STATE: CA	ZIP CODE:	93035
CAPACITY:	14	CENSUS: 12	DATE:	06/24/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Susana Muller		TIME COMPLETED:	03:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On June 24, 2020 at 1:00 PM Licensing Program Analyst (LPA) Laura Villanueva conducted a Required - 1 year inspection. LPA toured home inside and outside with Licensee. The 12 children were in the backyard with Licensee and Assistant. The fire extinguisher was service on 5/11/21. . Licensee is reminded to either service or purchase a regulation fire extinguisher every year.Licensee and Assistant's CPR/First Aid certification expires on 2/21/22. The Licensee uses the entire home for the child care. The fire place in the living room is completely screened. The smoke/carbon monoxide detectors were observed. The Licensee uses the back yard for the day care and it is completely enclosed by fences with gates. There are age appropriate toys and equipment. LPA reviewed the children roster. The last fire drill was conducted in 6/21. LPA reviewed children's files and found them to be complete. Licensee states that she does not have any guns/weapons on the property. Incidental Medical Services (IMS) policy was discussed. Licensee is not providing IMS at the present time. 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

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

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: MULLER FAMILY CHILD CARE	FACILITY NUMBER: 566211203
	VISIT DATE: 06/24/2021

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Licensee is reminded that she is responsible for knowing the regulations for a Family Child Care Home and that Licensing information can be accessed online at www.ccld.ca.gov.

LPA reviewed and provided Licensee with Guide to Infant Safe Sleep.

No deficiencies cited under Title 22 Division 12.

The LIC 9213 (Notice of Site visit) was posted during today's visit.

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) 562-0410
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 06/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021

LIC809 (FAS) - (06/04)

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