566215609-8-26-2021-17-CC-BCES-C69TU5-20210826150147

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215609
Report Date: 08/26/2021
Date Signed: 08/26/2021 03:02:01 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:	GONZALEZ FCC AKA LULU DAY CARE		FACILITY NUMBER:	566215609
ADMINISTRATOR:	BLANCA L. GONZALEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 612-3481
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	14	CENSUS: 3	DATE:	08/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Blanca L. Gonzalez		TIME COMPLETED:	03:05 PM

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	On August 26, 2021 at 1:00PM, Licensing Program Analyst (LPA) Betzayra Cervantes conducted an unannounced visit for the purpose of performing a Required- 1 Year inspection. LPA spoke to licensee Blanca L. Gonzalez and conducted a COVID-19 risk assessment prior to entering the home. LPA discussed the nature and purpose of the inspection. Licensee and LPA toured the facility inside and outside. Licensee was caring for 3 children at the time of the inspection. This facility is a two bedroom and two bathroom single story home. Licensee is utilizing the living room, kitchen, dining room, one bedroom which serves as a nap room, front yard, and one restroom for daycare. The master bedroom and 1 additional bathroom, and garage are off limits and made inaccessible with child safety knobs and locked with a key. LPA observed age appropriate toys and furnishings available for children in care in good condition and free of hazards. The smoke alarm & carbon monoxide detector were tested and found operational. A regulation 2A10BC fire extinguisher was purchased on 06/15/2021. LPA reminded licensee to either service or purchase a regulation fire extinguisher annually. LPA observed the home to be clean, orderly and void of hazardous items. The bathroom used by children in care is clean and free of toxins. LPA observed cleaning compounds and knives are stored in an elevated shelf in the kitchen. Toys and equipment observed in the FCCH are age appropriate. The front yard is fully fenced. The licensee states that she takes the children to a nearby park for nearby play. (CONT. 809-C)

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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: GONZALEZ FCC AKA LULU DAY CARE	FACILITY NUMBER: 566215609
	VISIT DATE: 08/26/2021

NARRATIVE

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A sampling of the children records were reviewed. The records were current and complete. A current roster of children was reviewed by the LPA and found up to date. The Licensee's Pediatric CPR and First Aid certificate is valid until 06/17/23. Last fire drill conducted on 8/9/21. LPA did not observe any bodies of water on site. Licensee stated that there are no firearms nor ammunition in the home.

Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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: www.ada.gov/childqanda.htm.

LPA discussed COVID- 19 guidance and best practices with the Licensee. Licensee was provided Infant Sleeping Plan and PIN 20-24-CCP. Licensee was reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time. Exit interview was conducted with licensee, Blanca L. Gonzalez . A copy of this report was reviewed and provided to the licensee. Inspection and report was conducted in Spanish.

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) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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