566213137-11-4-2019-17-CC-LVIA-BHLSRV-20191104130659

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566213137
Report Date: 11/04/2019
Date Signed: 11/04/2019 01:07:06 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:	RODRIGUEZ FCC AKA LEARNING ADVENTURES		FACILITY NUMBER:	566213137
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 6	DATE:	11/04/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Mireya		TIME COMPLETED:	01:15 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	Licensing Program Analysts (LPAs), Laura Villanueva and Betzayra Cervantes made an unannounced inspection in order to conduct an Annual/Random review and met with the licensee, Mireya Rodriguez The purpose of the visit was discussed and a tour of the one story home was conducted inside and outside. There are age appropriate toys and equipment present. Licensee had 6 children present. The home has a fireplace in the living room which was observed screened off and inaccessible to children. There is a small dog with his immunizations up to date. Licensee stated that there were no firearms in the home. Detergents and cleaning products are kept in a high cabinet in the kitchen inaccessible to the children. Licensee uses the living room, dining area, one bedroom (playroom) and hall bathroom. LPA toured these areas and found them free of toxins and hazards. Licensee stated that 2 bedrooms were off-limits to day-care children. LPA found these rooms secured during the visit. The home maintains a current Fire extinguisher purchased on 12/1/18. Licensee is reminded to service or purchase the fire extinguisher yearly. The home also maintains a working smoke and carbon monoxide monitor that meet the requirement. There was a current facility roster present. CPR/First for licensee was current with an expiration date of 1/23/20. Licensee conducts emergency disaster drills. Last drill was conducted on 4/12/19. Licensee will be conducting a fire drill within the next week. All adults in the facility have obtained a criminal record clearance. Licensee is current with SB792(Mendoza). Licensee completed Mandated Reporter Training on 7/25/18. Children files reviewed had all required documentation. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019

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: RODRIGUEZ FCC AKA LEARNING ADVENTURES	FACILITY NUMBER: 566213137
	VISIT DATE: 11/04/2019

NARRATIVE

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Licensee stated that there is no child on medication currently. 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

LPA provided information on Sudden Infant Death Syndrome (SIDS)Safe Sleep, Lead Poisoning Pamphlet, and a Child Care Program Fall 2019 Quarterly Update to Licensee.

Applicant was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

In the areas that were evaluated, no deficiencies cited under Title 22 Division 12.

LPA provided Licensee a “Notice of Site Visit" to post.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2019

LIC809 (FAS) - (06/04)

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