566213816-2-15-2022-17-CC-MMAW-CBNTEM-20220215134009

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566213816
Report Date: 02/15/2022
Date Signed: 02/15/2022 01:40:25 PM

Document Has Been Signed on 02/15/2022 01:40 PM - It Cannot Be Edited

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:	SEGOVIA FCC AKA THE SEGO BUNCH		FACILITY NUMBER:	566213816
ADMINISTRATOR:	SUSANA & GILBERT SEGOVIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 421-3476
CITY:	SANTA PAULA	STATE: CA	ZIP CODE:	93060
CAPACITY:	14	CENSUS:	DATE:	02/15/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:21 AM
MET WITH:	SUSANA GALLEGOS SEGOVIA		TIME COMPLETED:	01:55 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 2/15/2022 at 11:21am Licensing Program Analyst (LPA) Michael Mathew and Dean Thompson conducted an unannounced Random annual visit to the home. Met with Licensee, Susana Segovia and explained the purpose of the visit. LPAs tour of the one story home was made inside and out. The Licensee uses the living room, dining room, play room in the garage and one bathroom for the day care. The Licensee states that they do use the backyard. The pool does have a self latching lock and is not assessable to children. The kitchen/dining room and Master bedroom have sliding doors that lead onto the backyard and all these sliders have mounted locks at the top. LPA verified the locks are operable. Licensee understand that these doors must be maintained as locked at all times. The fireplace in the living room is screened making it inaccessible to children The bedrooms are closed making them inaccessible to children in care. The toxins are stored on a top cabinet in the kitchen making them inaccessible to the children. The regulation fire extinguisher was purchased on 6/9/2021. Licensee is reminded to either service or purchase a regulation fire extinguisher every year. The smoke detector and the carbon monoxide detector were observed to be functional. There are age appropriate toys and equipment. LPA reviewed the children roster. Licensee's First Aid/CPR certificates are valid through 6/2023. Licensee states that she does not have any guns/weapons on the property. Licensee has completed the Mandated Reporter Training on 5/16/2020. Licensee will renew Mandated Reporter Training. Assistant completed the mandated training on 9/10/2021 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 Continued on LIC 809C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022

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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Document Has Been Signed on 02/15/2022 01:40 PM - It Cannot Be Edited

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: SEGOVIA FCC AKA THE SEGO BUNCH	FACILITY NUMBER: 566213816
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/15/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(9)(A)1

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above Licensee did not conduct the six month fire dril. which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/01/2022
	Plan of Correction
1 2 3 4	Licensee will create a Fire drill sheet and conduct fire drill and will email LPA a copy of fire drill sheet.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022

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: SEGOVIA FCC AKA THE SEGO BUNCH	FACILITY NUMBER: 566213816
	VISIT DATE: 02/15/2022

NARRATIVE

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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.

Type B deficiencies were cited during today's visit.

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.,

Licensee Susana Segovia was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee Susana Segocia of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Exit interview conducted and report was reviewed with the licensee Susana Segovia

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2022

LIC809 (FAS) - (06/04)

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