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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214359
Report Date: 08/27/2020
Date Signed: 08/31/2020 10:44:38 AM

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:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
566214359
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
08/27/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
04:06 PM
MET WITH:Gloria LopezTIME COMPLETED:
05:05 PM
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On August 27, 2020 at 4:06 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted a case management inspection and met with Licensee, Gloria Lopez. Licensee requested to increase the capacity from small license (8 children) to large license (14 children). Due to COVID-19 and California Department of Public Health guidelines of social distancing, a tele-inspection was conducted via FaceTime in Spanish. LPA with the assistance of Licensee toured the entire home inside and outdoors.

This is a two story home that consists of, 4 bedrooms, 2.5 bathrooms, 2 living rooms, kitchen, garage and back yard. As you walk into the home there is a living room and stairs leading to the second floor. Licensee stated that the entire second floor and first living room is inaccessible to the children. LPA observed a small gate located on the first step of the stairs making the entire second floor inaccessible to children. LPA reminded Licensee that small gate must always be secured to ensure that second floor is inaccessible to children. LPA also observed another two small gates blocking off the first living room. One small gate was placed on the kitchen door and the other at the end of the hallway right where the second living room starts. Both gates block off the first living room and dining room. The main day care area consists of the second living room, 1/2 bathroom, and back yard. LPA observed play pens, children furniture and age appropriate materials accessible to children. The back yard is completely fenced and has plenty of age appropriate material accessible to children. LPA observed that door to the garage is locked and requires a key to be able to open it, making the garage inaccessible to children. In the kitchen, LPA observed that all bottom cabinets have safety latches and knives are stores on top of her counter.

The fire clearance was granted on 08/18/20 by the Oxnard Fire Department. The carbon monoxide and smoke detector were tested at 4:45 PM and were functioning at the time of the visit. Licensee is current with CPR and First Aid which expires on 05/23/2022. Licensee has submit her AB1207 Child Abuse Mandated Reporter Training which will expire on 7/20/2022. Licensee understands that she must renew her AB1207 certificate every two years. CONT.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2020
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: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 566214359
VISIT DATE: 08/27/2020
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LPA discussed the following information with applicant and provided written information via email: Sudden Infant Death Syndrome/Safe Sleep guidelines, Shaken Baby Syndrome, and COVID-19 guidelines and resources for her to post appropriately around her facility. LPA notified Licensee of mandatory Lead Training offered in September 2020 and reminded Licensee that the “Effects of Lead Exposure” brochure is to be distributed to all families at time of enrollment. It is the Licensee responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov. LPA informed Licensee that she can subscribe to receive Provider Information Notices (PINs) from Community Care Licensing Division via www.ccld.ca.gov

An exit interview was conducted with Licensee, Gloria Lopez via FaceTime in Spanish. . A copy of this report was reviewed and provided to the Licensee for her review and signature via email. Licensee agreed to receive a copy of report via email and will reply to email once she receives, reads and understands complete report. LPA requested Licensee return a signed copy of report by mail to our office.

The home meets Title 22 Division 12 requirements for a large Family Child Care home license. Licensee understands that LPA will forward this report to upper management for approval of change of capacity license. Furthermore, Licensee understands that her change of capacity license will not be effective until upper management gives final approval. LPA will communicate with Licensee once change of capacity has been approved and will give Licensee an exact date of when her large license will be effective.

A Notice of Site Visit was forwarded to the Licensee for posting (LIC 9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required may result in a $100.00 civil penalty.

On August 31, 2020, LPA received approval from LPM Mueller to move forward with change in capacity. LPA communicated with Licensee that approval was received and Large Family Child Care License is effective as of August 31, 2020.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca VelazquezTELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2020
LIC809 (FAS) - (06/04)
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