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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214359
Report Date: 08/22/2024
Date Signed: 08/22/2024 02:49:28 PM


Document Has Been Signed on 08/22/2024 02:49 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117



FACILITY NAME:LOPEZ FAMILY CHILD CAREFACILITY NUMBER:
566214359
ADMINISTRATOR:GLORIA LOPEZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 612-7863
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY:14CENSUS: 3DATE:
08/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:40 PM
MET WITH:Gloria Lopez TIME COMPLETED:
03:03 PM
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On August 22, 2024 at 12:40 PM Licensing Program Analyst (LPA) Aaliyah Zendejas and Shane Loftus conducted an unannounced annual/random inspection. LPAs met with licensee Gloria Lopez and advised them of the purpose of the inspection. Licensee provided LPAs a tour of the home inside and out. At the time of inspection there were 3 children under the care and supervision of two adults. Licensee denies having guns/ammunition in the home.

LPAs observed required Licensing required documents posted prominently at the entrance. Fire and earthquake drills are being documented every six months. Last drill was conducted on 05/03/24. Fire extinguisher 2A10BC mounted on the wall inside the home was last serviced May 06, 2024. Fire and carbon monoxide detectors were not tested due to children sleeping. Sharp objects and hazards are currently being kept on a high shelf out of reach of children in the kitchen area.

Children in care have access to, one restroom, the kitchen, living room, and enclosed back yard. Licensee has children currently napping in the living-room. LPA asked Licensee if they were conducting 15 minute safe sleep checks for the infants in care and licensee said they are not. Diapering needs are being met inside the living-room.Children have access to toys that are age-appropriate inside and outside of the home.There are no bodies of water present at the time of inspection. During the tour, LPAs did not observe any hazards/toxins items accessible to children in care.

LPAs reviewed five children files. All children files were current. A valid CPR/first aid was found with an expiration date of 10/08/2024. 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 Licensee’s mandated reporter certification had just recently expired and is in the process of redoing the training. LPA advised licensee to get it done and send in the certification to LPA. Licensee's assistant has a valid mandated reporter training that is valid until 10/13/2024.
Continued on 809-C
SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Aaliyah ZendejasTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024
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 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 566214359
VISIT DATE: 08/22/2024
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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.

LPAs 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. LPAs 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. Licensee does currently have infants in care.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: 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.

Continued on 809-C

SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Aaliyah ZendejasTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 566214359
VISIT DATE: 08/22/2024
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During the exit interview, the LICENSEE, Gloria Lopez, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

One deficiency was cited during today's visit. Please see 809-D for details.

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 in Spanish with the licensee, Gloria Lopez.

SUPERVISOR'S NAME: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Aaliyah ZendejasTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 08/22/2024 02:49 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117


FACILITY NAME: LOPEZ FAMILY CHILD CARE
FACILITY NUMBER: 566214359

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review the licensee did not comply with the section cited above in which LPA asked licensee if they were conducting safe sleep documenation and licensee said they were not which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 09/05/2024
Plan of Correction
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Document 15 minute safe sleep checks for the infants in care for two weeks. Send documentation to LPA through email within two weeks. If infants in care do not sleep, licensee if to write a note for weeks weeks stating the time the infant was dropped off and left and that they did not sleep. They must sign and the parent must sign.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Lissete GonzalezTELEPHONE: (805) -56-0400
LICENSING EVALUATOR NAME: Aaliyah ZendejasTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:
DATE: 08/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/22/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4