566213654-8-12-2019-17-CC-LVIA-BEYSTQ-20190812140956

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566213654
Report Date: 08/12/2019
Date Signed: 08/12/2019 02:10:02 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:	MADRIGAL FCC AKA EMILY'S PAMPERED TOT'S		FACILITY NUMBER:	566213654
ADMINISTRATOR:	MARIA MADRIGAL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 766-2276
CITY:	SANTA PAULA	STATE: CA	ZIP CODE:	93060
CAPACITY:	14	CENSUS: 6	DATE:	08/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Maria Madrigal		TIME COMPLETED:	02:00 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 Analyst (LPA), Laura Villanueva made an unannounced inspection in order to conduct an Annual/Random review. LPA met with Licensee, Maria Madrigal. A tour of the two story home was conducted. Licensee had 6 children present. Licensee stated that there were firearms in a safe. A pool is in the backyard with fencing meeting regulations. Cleaning supplies are on a high shelf in the kitchen pantry inaccessible to the children. Licensee uses the living room, dining area, one bedroom, bathroom, and day care room for the day-care. LPA toured these areas and found them free of hazards. The home maintains a current Fire extinguisher purchased on 1/28/19. 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 statutory requirement. There was a current facility roster present. CPR/First for licensee was not current with an expiration date of 6/2019. Licensee will be completing CPR/First Aid class on 8/17/19 and submitting certificate. The last fire drill was conducted on 1/1/17. Licensee will be conducting a fire drill and submitting proof to the department. Licensee's daughter turned 18 years old on 8/6/19. Licensee will be having her fingerprinted for a criminal record clearance. Licensee's daughter will also be having a TB test completed. Licensee needs a whooping cough immunization. Children files had all required documentation. Mandated reporter training has not been completed. LPA gave Licensee information on accessing website for the training. Licensee will submit certificate of completion for mandated reporter training to the department. 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: 08/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019

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: MADRIGAL FCC AKA EMILY'S PAMPERED TOT'S	FACILITY NUMBER: 566213654
	VISIT DATE: 08/12/2019

NARRATIVE

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Licensee stated that there are no children 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, Poisonous Plants Poster, Lead Poisoning flyer, Mandated Reporter Training pamphlet, and Child Care Quarterly Update for Summer 2019.

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.

Licensee will post the “Notice of Site Visit.”

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: 08/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2019

LIC809 (FAS) - (06/04)

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