566215794-7-22-2021-17-CC-ARIS-C56TKC-20210722144742

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215794
Report Date: 07/22/2021
Date Signed: 07/22/2021 02:47:52 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:	GASTELUM FAMILY CHILD CARE		FACILITY NUMBER:	566215794
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	07/22/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	01:58 PM
MET WITH:	Marisol Gastelum		TIME COMPLETED:	02:55 PM

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On 7/22/2021, Licensing Program Analyst (LPA) Austin Rios and Licensing Program Manager (LPM) Ana Tolentino met with Licensee Marisol Gastelum and explained the purpose of the inspection. LPA conducted a Pre-screening with licensee prior to entering the home. Licensee had one child in care at the time of the inspection. Together the LPAs and licensee toured the home inside and outside.

The licensee uses the family room, dining room, kitchen, one restroom, and backyard for the day-care. LPAs observed a lock on all bedroom doors making it inaccessible to children in care as well as the garage door. There are no bodies of water in the home. On 7/21/2021 Ventura County Fire Department conducted an inspection. Fire-Clearance for large facility was granted on 7/21/2021. The 2A10BC regulation fire extinguisher was observed in the kitchen with a service date of 5/27/2021. Toxins and hazards are inaccessible to the children. There are age appropriate toys and day-care equipment in the home. The back yard has age appropriate toys and day-care equipment. LPA advised licensee must provide visual supervision while the children are playing both inside the home and outside in the backyard. Licensee stated that there are no firearms or ammunition in the facility. First Aid/CPR certificates is valid until 6/8/2023.

LPA discussed and verified SB 792 (Child Care Employee and Volunteer: Immunization and Tuberculosis Requirements). was informed walkers, bouncers and any similar object that restricts children's movement are prohibited from licensed facilities.

Cont. on 809C.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin Rios	TELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

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: GASTELUM FAMILY CHILD CARE	FACILITY NUMBER: 566215794
	VISIT DATE: 07/22/2021

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LPA Rios reviewed COVID-19 guidelines/resources with Licensee. LPA also reminded Licensee of the new child care regulations for infants and to continue monitoring the CCLD website at www.ccld.ca.gov for updates.

Facility license will be a large family childcare effective today, July 22, 2021 for a capacity of 14 children.

A copy of this report was reviewed and provided to the licensee.

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: Ana Tolentino	TELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Austin Rios	TELEPHONE: (805) 635-4725
LICENSING EVALUATOR SIGNATURE:	DATE: 07/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2021

LIC809 (FAS) - (06/04)

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