566215222-4-7-2022-17-CC-MMAW-CD9V8Q-20220407161308

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215222
Report Date: 04/07/2022
Date Signed: 04/07/2022 04:13:18 PM

Document Has Been Signed on 04/07/2022 04:13 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:	ZAMBRANA FCC AKA GIGI'S NURTURING PLACE		FACILITY NUMBER:	566215222
ADMINISTRATOR:	REGINA A. ZAMBRANA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 509-6113
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93010
CAPACITY:	14	CENSUS: 5	DATE:	04/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	GINA A. ZAMBRANA		TIME COMPLETED:	04:27 PM

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On 4/7/2022 at 1:05 PM Licensing Program analyst (LPA) Michael Mathew conducted an unannounced annual visit LPA met with Licensee Gina Zambrana and discussed the purpose of the visit. Prior to entering the home LPA conducted Covid-19 screening questions. Licensee and LPA, toured inside and out of the home. At the time of the visit there were 5 children and 1 adult. Licensee usees cots and a crib for napping. There are age appropriate toys and equipment for children in care.

Licensee uses the living room, kitchen, one bathroom, and backyard for the day-care. Licensee stated that there are guns and ammunition in the home. LPA observed that the gun is kept in the master bedroom under the bed in a locked box. LPA also observed ammunition which is kept in a drawer next to the bed in a locked case, both gun and ammunition are stored separately in an off limit area of the home which is inaccessible to children in care .LPA observed the knifes are kept in the top cabinet in the kitchen next to the fridge which is inaccessible to children.LPA observed chemicals and toxins are kept in the garage which is inaccessible to children in care. Backyard is fully fenced in and have ample amount of toys and equipment for children in care. LPA observed no bodies of water during inspection. There is also a dog which stays in the master bedroom which is inaccessible to children in care, licensee states that the dog does not interact with the children. There was one infants-C1 in care. LPA reviewed an Individual Sleeping Plan (LIC9227) on file. LPA observed a 2A10BC fire extinguisher present and Purchased on 9/6/21. Fire alarm and carbon monoxide detector are good and in working condition. Licensee did not test fire alarm or carbon monoxide detector since children were sleeping at the time of inspection. Licensees pediatric CPR/first aid is current and is valid until 8/7/23. Licensee mandated reporter training is current and valid till 4/7/2024.Last fire drill was conducted on 1/7/22.

Cont on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

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: ZAMBRANA FCC AKA GIGI'S NURTURING PLACE	FACILITY NUMBER: 566215222
	VISIT DATE: 04/07/2022

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Licensee does not provide incidental medical service at this time.. Licensee was reminded a plan for Providing IMS must be submitted to the Department. if licensee provides IMS. 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

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/inspection-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.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee.

no deficiency were cited in todays visit.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Michael Mathew	TELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

LIC809 (FAS) - (06/04)

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