566213816-7-18-2023-17-CC-DMWT-CTUNSV-20230718104346

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566213816
Report Date: 07/18/2023
Date Signed: 07/18/2023 10:44:27 AM

Document Has Been Signed on 07/18/2023 10:44 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CENTRAL COAST-CHILD, 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: 5	DATE:	07/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Susana Segovia		TIME COMPLETED:	11:00 AM

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 07/18/2023, at 8:30 AM, Licensing Program Analyst (LPA) Dixie Wright conducted an unannounced Required Annual inspection of this Family Child Care Home (FCCH). LPA met with Susana Segovia, Licensee, and toured the interior and exterior of the FCCH. The living room, dining room, hallway bathroom, kitchen, back room to the right in the hallway and the front yard are used for child care, while the remainder of the home is excluded. LPA observed five children on site, (one infant). LPA observed required licensing forms and documents posted on the wall by the front door. LPA observed a smoke alarm and carbon monoxide detector in the hallway, both tested at 8:35 AM and functioning. The FCCH has a regulation fire extinguisher, last serviced on 03/25/2023. Licensee is aware to either service or purchase a regulation fire extinguisher annually. Last fire drill was done 05/02/2023. LPA observed age appropriate toys, furniture and equipment in the FCCH's interior. LPA observed the restroom used by children to be clean and free of toxins. Medications/vitamins are stored in an elevated cabinet in the kitchen inaccessible to children. LPA observed cleaning compounds in an elevated cabinet in the kitchen, inaccessible to children. Sharps in the FCCH are stored in an elevated cabinet in the kitchen, inaccessible to children. The backyard is enclosed by wooden fencing and the footing in the area is cement. Toys and play equipment observed on site are age appropriate. The outdoor fence's entry/exit gate on the side of the house was closed, but unlocked. LPA observed a built in swimming pool in the backyard with the gate door open. The back sliding glass door in the kitchen leading to the backyard was locked and secure, however the side gate was unlocked. Licensee locked the side gate and pool gate while LPA was present. The door to the gate around the pool swings toward the pool, not away from the pool. (CONT. LIC 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie Wright	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: SEGOVIA FCC AKA THE SEGO BUNCH	FACILITY NUMBER: 566213816
	VISIT DATE: 07/18/2023

NARRATIVE

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Children's records were reviewed. The records are current, complete and possessed emergency contact information as well as immunization records. Licensee did not have documentation noting the infant's sleep checks have been conducted in 15 minute intervals for infant in care. Facility roster for children in care is current. The Licensee's records were also reviewed. Licensee's Pediatric CPR and First Aid (EMSA approved) expires on 06/04/25 and Assistant's expires 06/24/2024. Licensee's Mandated Reporter training expires 03/29/2024 and Assistant's expires 08/23/2024. There are no guns or ammunition stored on the premises.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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 web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

Continued on 809-D...

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie Wright	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: SEGOVIA FCC AKA THE SEGO BUNCH	FACILITY NUMBER: 566213816
	VISIT DATE: 07/18/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee Susan Segovia confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights given.

Deficiency cited on 809-D.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie Wright	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/18/2023 10:44 AM - 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
CENTRAL COAST-CHILD, 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: 07/18/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102417(g)(5)(A)

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: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above which poses an immediate safety risk to children in care. LPA observed the swimming pool gate unlocked and open. The gate swings towards the swimming pool, and is supposed to swing away from the swimming pool. Although the back sliding glass door leading to the backyard was locked, LPA observed the gate on the side of the house that leads from the front yard to the backyard unlocked. Immediate civil penalty of $500 will apply.
	POC Due Date: 07/25/2023
	Plan of Correction
1 2 3 4	Licensee stated the backyard is not being used for Day Care activities at the moment. Licensee locked the pool gate and the gate on the side of the house while LPA was present. Licensee stated she will ensure the gates remain locked. Licensee will fix the gate door to the pool so that it swings away from the swimming pool. Proof of Correction will be sent to CCLD by 07/25/2023.

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: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Dixie Marie Wright	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023

LIC809 (FAS) - (06/04)

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