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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406212735
Report Date: 12/15/2022
Date Signed: 12/15/2022 03:46:36 PM

Document Has Been Signed on 12/15/2022 03:46 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:ZARATE FCC AKA RISING STARS CHILD CAREFACILITY NUMBER:
406212735
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
12/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Martha ZarateTIME COMPLETED:
03:48 PM
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On 12/15/2022 at 1:30 PM Licensing Program Analyst Gigi Reyes conducted an unannounced 1 Year Required inspection. LPA asked pre screening questions related to COVID- 19 and licensee’s responses indicate there are no COVID 19 exposures on site. LPA met with licensee, Martha Zarate and discussed the purpose of the inspection. There were 3 children present at the time of the inspection. On or about 2:00 PM Licensee stated she had to leave to pick up a school age from nearby Elementary School. LPA left and came back at 2:30PM. Licensee picked up one child from school having a total of 4 children in care.

LPA in the company of Licensee toured the interior and exterior of the day care. Living room, kitchen, dining room, one bedroom, fenced backyard are the areas accessible to children, The home has a second floor, a living quarter with separate entrance and is not accessible to children. LPA observed required licensing forms are posted in the FCCH. LPA observed dual smoke and carbon monoxide detectors which were tested and found functional. The regulation fire extinguisher was serviced on 10/4/2022. Licensee conducts and documents fire and disaster drill every 6 months last drill was conducted on 7/28/2022.

The play yard is enclosed by wooden and brick fence. LPA observed age appropriate toys and play equipment. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the home

LPA Reyes reviewed facility file, Pediatric CPR and First Aid expires on 6/4/2024. L Licensee's Mandated Reporter Training Certificate expires on 7/18/2024. Licensee has proof of immunization record on file. FCCH has current roster of children in care. A sampling of children records were reviewed and found to be current. File contains Emergency and Identification cards. Licensee has liability insurance for FCCH business.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2022
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: ZARATE FCC AKA RISING STARS CHILD CARE
FACILITY NUMBER: 406212735
VISIT DATE: 12/15/2022
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No deficiencies were cited during today's inspection.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home 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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

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 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
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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Martha Zarate
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2022
LIC809 (FAS) - (06/04)
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