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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213137
Report Date: 10/09/2020
Date Signed: 10/12/2020 04:07:21 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 ADVENTURESFACILITY NUMBER:
566213137
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
10/09/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Mireya RodiguezTIME COMPLETED:
03:30 PM
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On October 9, 2020 at 3:00 PM, Licensing Program Analyst (LPA) Laura Villanueva made an announced telephone call to Licensee to conduct a Case Management inspection for increase in capacity. LPA met with Licensee, Mireya Rodriguez and advised her on the purpose of the inspection. LPA advised licensee that due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing, a tele-inspection will occur. LPA confirmed with licensee that she had video capabilities with her phone and switched to Facetime to conduct the inspection.
LPA toured the inside and the outside of the one story house though a virtual call. No toxins or hazards are accessible to the children in care. The Licensee uses the entire home with the exception of the master bedroom for the child care. The back yard is completely enclosed. Fire clearance was granted 09/17/2020. The fire extinguisher was serviced on 1/20/20. Licensee's CPR first Aid certificate expires 1/8/22. Mandated reporter training was completed on 8/16/20.

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 Licensee with Safe Sleep information, capacity requirements, and COVID 19 resources.

Licensee is granted a capacity increase from a small family child care home to a large family child care home. Large license is effective today 10/9/20.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura VillanuevaTELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2020
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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