566214306-7-20-2021-17-CC-BCES-C54UBM-20210720152634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566214306
Report Date: 07/20/2021
Date Signed: 07/20/2021 03:26:43 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 FAMILY CHILD CARE		FACILITY NUMBER:	566214306
ADMINISTRATOR:	CRESENCIA RODRIGUEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 290-8803
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	14	CENSUS: 9	DATE:	07/20/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Cresensia Rodriguez		TIME COMPLETED:	03:40 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 7/20/21, at 1:05 PM, Licensing Program Analyst (LPA) Betzayra Cervantes made an unannounced visit to conduct a Required - 1 Year Inspection and a Case Management inspection. LPA met with licensee Cresensia Rodriguez and explained the purpose of the inspection. Prior to entering the facility, LPA conduted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA, in the company of the Licensee toured the interior and exterior of the facility. The living room, dining room, kitchen, hallway bathroom and backyard are used for child care, while the four bedrooms, and one bathroom are excluded from child care. There were 9 children in care with 4 assistants in care at the time of the inspection. Required forms and documents are posted on a bulletin board which is resting on the wall in the living room. The main child care is in the backyard with a area has sufficient age appropriate toys for children in care, found in good condition and free of hazards. LPA observed the completed construction of an enclosed pavilion in the backyard which was found to be safe for children's use. The smoke alarm & Carbon Monoxide were tested and found operational. A regulation 2A10BC fire extinguisher was serviced on 2/18/2021 and was observed mounted on the kitchen wall. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log and noted the most recent fire/disaster drill occurring on 6/30/21. LPA observed the home to be clean, orderly and void of hazardous items. The bathroom used by children in care is clean and free of toxins. Medication in the FCCH is stored in an elevated cabinet in the kitchen which is outside the reach of children and in an area made inaccessible to children in care. Toxins and cleaning compounds are also secured in kitchen area cabinet and in an elevated shelf in the bathroom. Each location is inaccessible to children in care. Toys and equipment observed in the FCCH are age appropriate. The backyard patio is fully fenced. Toys observed in backyard patio are age appropriate. No bodies of water were observed on site. LPA observed four locked storage sheds in the backyard making it inaccessible to children in care. LPA observed two small dogs enclosed in the side yard. (CONT. 809-C)

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

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: RODRIGUEZ FAMILY CHILD CARE	FACILITY NUMBER: 566214306
	VISIT DATE: 07/20/2021

NARRATIVE

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Licensee reported that both (2) dogs are licensed and their vaccinations are up to date.
A sampling of the children records were reviewed. The records were current and complete. A current roster of children was reviewed by the LPA and found up to date. The Licensee's records are also current and complete with Pediatric CPR and First Aid certifications valid until 2023 and Mandated Reporter training expiring on 12/18/21. Licensee states that there are no firearms and ammunition in the home.

Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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: www.ada.gov/childqanda.htm.

LPA discussed COVID- 19 guidance and best practices with the Licensee. Licensee was provided PIN 20-24-CCP - Recently Approved Safe Sleep Regulations In Effect and LIC 9227 (Infant Sleeping Plan). Licensee was reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

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

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 07/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021

LIC809 (FAS) - (06/04)

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