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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566213955
Report Date: 04/27/2023
Date Signed: 04/27/2023 01:28:31 PM


Document Has Been Signed on 04/27/2023 01:28 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:RIVERA FAMILY CHILD CAREFACILITY NUMBER:
566213955
ADMINISTRATOR:BERENICE RIVERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 766-8448
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:14CENSUS: 1DATE:
04/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:25 AM
MET WITH:Berenice RiveraTIME COMPLETED:
01:42 PM
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On April 27, 2023, Licensing Program Analysts(LPAs) Susana Martinez and Giovani Gonzalez conducted an unannounced 1- year Required visit. LPAs met with Licensee Berenice Rivera and advised her the purpose of the visit. At the time of the inspection there was one child in care and no other adults in the home.

All licensing documents were prominently posted. Last earthquake drill was observed to be conducted on 03/18/22. A technical advisory is being issued for not conducted disaster drills every 6 months. Fire extinguisher 2A10BC is mounted to the wall in the play area with a receipt showing a purchase date of 10/25/22. LPAs reminded the Licensee that a regulatory fire extinguisher must be purchased or serviced yearly. Fire and Carbon monoxide detectors were tested at 11:30 am and were found to be operational.

The home has 2 bedrooms and 2 bathrooms. One bedroom, one bathroom, living room and driveway are used for child care. Together with the Licensee LPAs toured the interior and exterior of the home. Age appropriate toys and learning materials were found in the living room, bedroom and outdoor play area. Bathroom was found in working condition and no toxins or hazardous items were accessible to children in care. The kitchen was found to be clean and orderly all sharps were observed to be out of reach of children in care and the cleaning supplies were observed to be out of reach as well. The outdoor area is fenced and contains age appropriate play structures.

LPA reviewed 1 of 1 children's files. Child's file was found to be current and complete. Licensee CPR/first aid is valid through 10/30/24. A Technical Violation was issued since the Licensee does not have a current Mandated Reporter Certificate. Licensee was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. LPAs provided a handout regarding on how to obtain the Mandated Reporter certification.

Cont. 809-C
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:
DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


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: RIVERA FAMILY CHILD CARE
FACILITY NUMBER: 566213955
VISIT DATE: 04/27/2023
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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.

Licensee 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 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. LPAs provided licensee with PIN 20-24-CCP SP, LIC 9227 and a safe sleep log. Licensee does not currently care for infants, but might consider in the near future.

Licensee advised there were no children in care that required Incidental Medical Services. 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

There were no deficiencies cited during todays inspection. A technical violation was given for Mandated Reporter and a technical advisory was given for emergency and disaster drills.

A notice of site visit was given and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee Berenice Rivera. Report was reviewed in Spanish.

SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Susana MartinezTELEPHONE: 805-689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 04/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/27/2023
LIC809 (FAS) - (06/04)
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