566215852-9-20-2019-17-CC-EBAY-BG7NQ6-20190920103926

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215852
Report Date: 09/20/2019
Date Signed: 09/20/2019 10:39:38 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:	AGUILERA DE MARQUEZ FAMILY CHILD CARE		FACILITY NUMBER:	566215852
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 0	DATE:	09/20/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Adriana Aguilera		TIME COMPLETED:	11:00 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 Analyst (LPA) Michael Avila and LPA Elvin Baddley made an announced visit to conduct a Pre-Licensing Inspection for the abovementioned Family Child Care Home (FCCH). LPAs met with Adriana Aguilera, the applicant of the FCCH and explained the nature, purpose and scope of the inspection. There were no children on site at the time of the inspection. In the company of the applicant, the LPAs toured the interior and exterior of the home. The FCCH is a 3 bedroom, 2 bath single home dwelling. The Applicant stated the home’s living room, backyard and hallway bathroom will be used for child care, while the home’s bedrooms, garage, and bedroom bathroom will be excluded/off limits from child care services. The home’s living room was partitioned with a child safety gate. The portion of the living room used for home care was orderly and contained age appropriate toys, equipment and furniture. The home’s bathroom to be used for children care was observed to be clean and free of toxins. Medication in the home is secured in a cabinet in a shelf which elevated and beyond the reach of children. The kitchen was clean and orderly. Sharps were placed on an elevated cabinet beyond the reach of children. Likewise detergents and cleaning compounds are stored in a locked cabinet under the sink and inaccessible to children. The LPA observed a functioning combination carbon monoxide / smoke alarm detector affixed to the home’s main hallway wall as well as a 2A10BC fire extinguisher on site which was serviced on 9/4/19. The home has appropriate heating and ventilation to afford children comfort and safety. The outdoor play area/backyard is completely enclosed with a brick fence. Toy and play equipment in CONT. 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

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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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: AGUILERA DE MARQUEZ FAMILY CHILD CARE	FACILITY NUMBER: 566215852
	VISIT DATE: 09/20/2019

NARRATIVE

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the outdoor play area is sufficient for the capacity of the FCCH, varied and age appropriate. The outdoor play area is also free of hazards. Additionally, no bodies of water were observed on site.

The applicant completed AB 1207 Mandated Reporter training on 8/6/19. Further, the applicant completed Preventative Health training on 8/24/19. The Applicant’s Pediatric CPR and First Aid certificate expires 6/11/21. The applicant stated there are no guns or ammunition in the home. The applicants mortgage records/transaction History was reviewed.

Applicant is not providing 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

LPA discussed AB 633 and handed Pre-licensing packet to applicant. The LPA reviewed and issued the applicant updated samples of state required forms to be kept in the children's record. The LPA also discussed and provide the applicant information of Sudden Infant Death Syndrome, Guidelines to safe sleep and Never Shake a Baby brochure. The Applicant was informed that baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours. Applicant has 2 pet dog which are licensed and vaccinated. Applicant was made aware that it is their responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

No deficiencies cited during this visit. License to operate a Family Child Care Home is effective today, 9/20/19. .

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: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2019

LIC809 (FAS) - (06/04)

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