566215509-11-12-2019-17-CC-FPEA-BHUQTV-20191112112746

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215509
Report Date: 11/12/2019
Date Signed: 11/12/2019 11:27:53 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:	BARCEGA FAMILY CHILD CARE		FACILITY NUMBER:	566215509
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 5	DATE:	11/12/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Candida Barcega		TIME COMPLETED:	11:45 AM

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

Licensing Program Analysts (LPAs) Francisco Pedroza and Betzayra Cervantes conducted an unannounced Annual Random inspection. LPAs met with Licensee Candida Barcega and advised her the purpose of the inspection. LPAs and licensee together toured the facility inside and out. There was five children in care at the time of the inspection.

The licensee uses the kitchen, family room, one restroom, and back yard for the day care. Licensee states that there are no firearms and ammunition in the home. LPAs did not observe toxins/hazards accessible to children in care. There are age appropriate toys and furniture readily accessible to children. The home has working smoke and carbon monoxide detectors. The detectors were not tested during the inspection because children were napping. A 2A10BC fire extinguisher was observed stored in a kitchen cabinet with a last service date of 06/27/2019. The backyard is fully enclosed with a concrete wall. Licensee has a secured fence in the backyard that leads to a fenced off area preventing children from having access. There is an outdoor storage unit located in that fenced off area that is secured. Licensee has age appropriate toys and play structures in the backyard readily accessible to children.

A roster of children in care was observed current and complete. A sampling of children records was reviewed and found current. LPA verified SB 792 Child Care Adult Immunization and Tuberculosis Requirements.

Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 11/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2019

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: BARCEGA FAMILY CHILD CARE	FACILITY NUMBER: 566215509
	VISIT DATE: 11/12/2019

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
26
27
28
29
30
31
32

Licensee does not have liability insurance for their facility. LPAs observed a liability insurance waiver in each child's file. First-Aid and Pediatric CPR is current until 06/23/21. Mandated Reporter training has not been completed yet. The Fire/Emergency drill was completed on 08/08/2019. LPAs discussed Incidental Medical Services (IMS) with licensee. Licensee currently does not have children in care that require IMS. LPAs discussed and provided licensee an AB 2370 Lead Exposer guide and Safe Sleep pamphlet.

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

No deficiencies were cited during today's visit.

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) 562-0410
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 11/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2