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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212656
Report Date: 10/18/2019
Date Signed: 10/18/2019 01:26:27 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:TORREY FAMILY CHILD CAREFACILITY NUMBER:
566212656
ADMINISTRATOR:ELIZABETH TORREYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 582-4976
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY:14CENSUS: 7DATE:
10/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Elizabeth TorreyTIME COMPLETED:
01:40 PM
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Licensing Program Analysts (LPAs) Betzayra Cervantes and Francisco Pedroza made an unannounced visit to conduct a Annual/Random inspection. LPA's met with licensee Elizabeth Torrey and discussed the nature/purpose of the visit. Together, LPAs and licensee conducted a tour of the home both inside and outside. Licensee and one assistant were caring for seven children at the time of the inspection.

The licensee uses the play room, preschool room, living room, family room, one restroom, kitchen, and back yard for the day care. Licensee states that there are no fire arms and ammunition in the home. LPAs did not observe toxins/hazards accessible to children in care. LPAs observed a fireplace with a glass screen in the living and family room preventing children from having access. There are age appropriate toys and furniture readily accessible to children. The home has a dual working smoke and carbon monoxide detector. A 2A10BC fire extinguisher was observed mounted in the garage with a last service date of 06/15/2019. The backyard is fully fenced and free of hazards. Licensee has two family dogs and is reminded to provide supervision at all times. Licensee has age appropriate toys and play structure in the backyard readily accessible to children. Continued on 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019
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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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: TORREY FAMILY CHILD CARE
FACILITY NUMBER: 566212656
VISIT DATE: 10/18/2019
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A roster of children in care was observed current and complete. A sampling of children records was reviewed and found current. LPAs verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements. First-Aid and CPR is current until 09/7/2021. Mandated Reporter training is current until 02/06/2020. The Fire/Emergency drill was completed on 10/09/2019. LPAs discussed Incidental Medical Services (IMS) with licensee. Licensee currently does not have children in care that require IMS. LPAs discussed and provided licensee AB 2370 Lead Exposer guide and Safe Sleep pamphlet.

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

No deficiencies were cited 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 MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019
LIC809 (FAS) - (06/04)
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