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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215851
Report Date: 10/07/2021
Date Signed: 10/07/2021 03:15:08 PM

Document Has Been Signed on 10/07/2021 03:15 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 FAMILY CHILD CAREFACILITY NUMBER:
406215851
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 2DATE:
10/07/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Perla AlvaradoTIME COMPLETED:
03:45 PM
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On 10/7/21, at 2:00 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Perla Alvarado, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. The home’s living room, kitchen, hallway bathroom, bedrooms and side yard are used for child care. At the time of the inspection two children (biological) are present.

LPA observed required licensing forms and documents post on the wall in FCCH's kitchen and outside the door entry. LPA observed a combination smoke and a carbon monoxide detector in the FCCH. The detector was tested (2:48 PM) and found to be operable. LPA observed a regulation fire extinguisher in the FCCH's laundry room which was serviced on 3/12/21. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually.

LPA observed the FCCH to be clean and orderly. The bathroom which is used for care is clean and free of toxins. LPA observed cleaning compounds on the shelf of an elevated cabinet in the laundry room which is inaccessible to children in care. LPA also observed medications in the FCCH stored on elevated cabinet in the laundry room which is also inaccessible to children in care. Toys, furniture and equipment in the FCCH are age appropriate.

The FCCH's side yard has cinder block fencing. The side area is not enclosed. As such the LPA, reminded the Licensee to ensure direct supervision is maintained when the area is used for activities. Toys and play equipment observed in backyard are age appropriate. LPA observed no bodies of water on site.

LPA reviewed a sampling of the children's records. All records reviewed are current and complete. A current roster of children was reviewed by the LPA as was emergency contact information and immunizations. LPA also reviewed the Licensee's records. The Licensee's records are current and complete with
(CONT-809)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2021
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: ALVARADO FAMILY CHILD CARE
FACILITY NUMBER: 406215851
VISIT DATE: 10/07/2021
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Pediatric CPR and First Aid certifications expiring in 9/13/23 (EMSA approved) and Mandated Reporter training expiring on 10/7/23.

Licensee informed LPA no firearms or ammunition are stored on site.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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: www.ada.gov/childqanda.htm

LPA discussed COVID 19 guidance and best practices with the Licensee. Licensee is reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

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
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2021
LIC809 (FAS) - (06/04)
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