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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215569
Report Date: 10/18/2019
Date Signed: 10/18/2019 01:09:38 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:SANTACRUZ FCC AKA ADVENTURES FAMILY CHILD CAREFACILITY NUMBER:
566215569
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
10/18/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:16 PM
MET WITH:Maria SantacruzTIME COMPLETED:
01:30 PM
NARRATIVE
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Licensing Program Analyst (LPA) Michael Avila made an unannounced visit for the purpose of conducting an Annual Random facility inspection. LPA Avila met with Licensee Maria Santacruz and discussed the nature and purpose of the visit. A tour of the facility was conducted with Licensee. Licensee states there are no firearms stored on the property. A 2A10BC fire extinguisher was observed mounted on the wall with a service tag 4/26/19. A smoke and carbon monoxide detector were observed on the wall. No toxins nor hazards were observed accessible to children. The backyard is fully enclosed with a gated fence. No bodies of water were observed on the property. Licensee has a pet dog which are licensed and vaccinated. LPA Avila reminded Licensee it is her responsibility to provide supervision of children when they are playing with the pets. Children's records were reviewed. Licensee's CPR/First-Aid is current until 1/20/20. Mandated Reporting training certificate was observed with a date of 5/15/2019. LPA Avila discussed Safe Sleep and reviewed video on the Department website. LPA reminded Licensee it is her responsibility to be aware of all child care regulations which can be accessed at www.ccld.ca.gov.

Licensee denies taking care of any children who require incidental medical services. 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 issued during this facility inspection.

This visit was conducted in Spanish.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Michael AvilaTELEPHONE: (805) 722-5133
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019
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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