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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406211764
Report Date: 04/17/2023
Date Signed: 04/17/2023 12:40:57 PM

Document Has Been Signed on 04/17/2023 12:40 PM - It Cannot Be Edited

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:ALVARADO FCC AKA ELENITA'S DAY CAREFACILITY NUMBER:
406211764
ADMINISTRATOR:MARIA ALVARADOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 994-7008
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/17/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Maria AlvaradoTIME COMPLETED:
12:50 PM
NARRATIVE
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On 04/17/23 at 9:50 AM, Licensing Program Analyst (LPA) Francisca Velazquez and conducted an unannounced One Year Required Inspection of the Family Child Care Home (FCCH). LPA met with Maria Alvarado Licensee of the FCCH and explained the purpose of the inspection. LPA notes COVID Pre-screening questions were asked of Licensee prior to the inspection. The Licensee's responses suggest the FCCH is void of COVID positive cases. At the time of the inspection, LPA observed there were no children on site during this inspection. There are three (3) adults that live in the home and all three (3) adults have received fingerprint clearance.

LPA, in the company of Licensee toured the interior and exterior of the FCCH. This home is a two-story home consisting of living room, dining room, kitchen, three (3) bedrooms, two bathrooms, garage, and outdoor yard. The FCCH’s living room, dining area, kitchen, one (1) bedroom, one (1) bathroom and outdoor yard are accessible for childcare services. Meanwhile, the entire second floor that consists of two (2) bedrooms, one (1) bathroom and garage are off-limits to children in care. LPA observed the garage to be locked and LPA observed a gate located on the first step of the stairway, making the entire second floor inaccessible.

The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. LPA observed a fireplace in the living room that is secured and locked with safety latch. In the kitchen, LPA observed sharps are stored in an elevated cabinet. Medication for the family is stored Licensee’s bedroom closet in an elevated shelf and in the children’s bathroom in an elevated cabinet. LPA observed cleaning compounds are stored in the garage. LPA notes all areas are inaccessible to children in care. The bathroom used for childcare is clean and free of toxins. LPA observed toys, furniture, and equipment in the FCCH are age appropriate and in good condition. LPA notes there are plenty of activities for children indoors and outdoors. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 04/17/2023 12:40 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 04/17/2023 at 11:40 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ALVARADO FCC AKA ELENITA'S DAY CARE
FACILITY NUMBER: 406211764

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)1
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation shall kept at the family child care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in that the last drill was conducted 8/16/2022 which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2023
Plan of Correction
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Licensee agrees to conduct and doucment an emergency drill by 04/24/2023 and send proof via email to francisca.velazquez@dss.ca.gov by 04/24/2023.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 04/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/17/2023


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Document Has Been Signed on 04/17/2023 12:40 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 04/17/2023 at 11:40 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ALVARADO FCC AKA ELENITA'S DAY CARE
FACILITY NUMBER: 406211764

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/17/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in that mandate reporter certifacte expired 11/12/2022 and it has not been updated which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/24/2023
Plan of Correction
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Licensee's agress to update mandated reporter certificate and submit proof by 04/24/2023 via email to francisca.velazquez@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 04/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/17/2023


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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: ALVARADO FCC AKA ELENITA'S DAY CARE
FACILITY NUMBER: 406211764
VISIT DATE: 04/17/2023
NARRATIVE
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Required forms are predominantly posted on the entrance of the FCCH. LPA observed a combination smoke and carbon monoxide detector in the FCCH. Detector was tested at 10:39 AM and was found to be operable. The FCCH has a regulation fire extinguisher on site which was serviced on 03/07/2023. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services. The Licensee informed LPA no firearms or ammunition are stored on site.

LPA and licensee toured the outdoor yard. The outdoor yard is fenced, and all exits are secured. LPA observed children yard has plenty of natural shading to afford the children in care. Children have access to filtered water by means of individual water bottle that are labeled. LPA observed there are plenty of toys, furniture and equipment that is age appropriate and in good conditions. LPA observed there are no bodies of water on sire.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records. Licensee does not have any infant age children enrolled; therefore 15-minute sleep checks were not reviewed. LPA and licensee discussed reviewing and understanding infant safe sleep regulations prior to enrolling any infants in the FCCH. A review of the FCCH's fire drill log shows the last drill occurred on 8/16/2022. The Licensee's records were reviewed. Licensee’s pediatric CPR and First Aid certification expires on 12/02/2024. Licensee’s Mandated Reporter training certificate expired 11/12/2022.

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

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023
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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: ALVARADO FCC AKA ELENITA'S DAY CARE
FACILITY NUMBER: 406211764
VISIT DATE: 04/17/2023
NARRATIVE
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LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an for additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Maria Alvarado in Spanish due to Spanish being licensee’s primary language.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2023
LIC809 (FAS) - (06/04)
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