566216200-11-1-2021-17-CC-FPEA-C8CTWH-20211101150533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566216200
Report Date: 11/01/2021
Date Signed: 11/01/2021 03:05:39 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:	VERONICA FCC AKA ABC LEARNING TREE		FACILITY NUMBER:	566216200
ADMINISTRATOR:	CINTIA VERONICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 416-3083
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93065
CAPACITY:	14	CENSUS: 0	DATE:	11/01/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Cintia Veronica		TIME COMPLETED:	03:20 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	This is a change of location, previous facility number 566215318 at 1806 Denham Court Simi Valley, CA. On November 1, 2021 at 1:40 PM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an announced inspection. LPA met with Licensee Cintia Veronica and advised her the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. There were no children in care at the time of the inspection. The home is a two (2) story home with three (3) bedrooms and one (2) bathrooms upstairs and one (1) bedroom with a bathroom downstairs. Licensee advised that upstairs and the kitchen is off-limits to the children in care. LPA observed a gate at the bottom of the stairs and the entrance of the kitchen preventing children from having access. Licensee will be using the living room, modified garage, bedroom downstairs, one (1) restroom, and back yard for children in care. The facility received an approved fire clearance from Ventura County Fire Department (VCFD) on 10/25/2021. Licensee advised she contacted Simi Valley Building and Safety as required by VCFD regarding if she would need to have a permit to use the modified garage. Licensee advised that per Building and Safety she is not required to have a permit as long as she does not have a person living in the garage. The garage will only be used for day care activities especially during times of inclement weather. A regulation 2A10BC fire extinguisher was purchased on 10/3/2021 was observed mounted on the wall in the garage readily accessible. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed the smoke detector and carbon monoxide detectors are functioning. There are age appropriate toys and day-care equipment in the home readily accessible to children. The back yard is divided in two sections with a wooden fence. One side of the backyard that is accessible from the living room is off-limits. The licensee has a swimming pool on this side. There is a six foot fence with a gate that swings away from the swimming pool. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021

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: VERONICA FCC AKA ABC LEARNING TREE	FACILITY NUMBER: 566216200
	VISIT DATE: 11/01/2021

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Licensee has the gate latch locked and secured with lock requiring a key preventing children from having access to the pool. There is a gate on the fence to the other side of the fence where the day care children will have access to. The gate requires a key to unlock the gate to enter from either side. Licensee advised to ensure the locks are always secured preventing children from having access. Children will have access to their side of the backyard from the garage. LPA advised Licensee must provide visual supervision while the children are playing outside in the backyard. LPA observed age appropriate toys and play structures available for children in care. Licensee advised there are no firearms and/or live ammunition in the home. Licensee showed LPA proof of a control of property.

LPA reviewed, discussed and gave applicant updated samples of state required forms to be kept in the children's file, required forms to be posted and forms that needs to be maintained at the FCCH. LPA discussed information about Covid-19 and Safe sleep. Applicant was made aware that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.cdss.ca.gov.

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.html

No deficiencies cited during today's inspection. License to operate a Large Family Child Care facility is effective today 11/1/2021.

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: Francisco Pedroza	TELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2021

LIC809 (FAS) - (06/04)

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