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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216263
Report Date: 10/08/2024
Date Signed: 10/08/2024 12:05:13 PM

Document Has Been Signed on 10/08/2024 12:05 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:SALGUERO FAMILY CHILD CAREFACILITY NUMBER:
406216263
ADMINISTRATOR/
DIRECTOR:		IRMA SALGUEROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 931-4366
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 10DATE:
10/08/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Irma SalgueroTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 10/8/2024 at 9:00 AM, Licensing Program Analyst conducted an unannounced Plan of Correction inspection at the above Family Child care Home (FCCH) as a follow up to the Annual Inspection conducted on 9/27/2024. LPA met with Licensee, Irma Salguero and Assistant, Mirna Leon and discussed the purpose of the inspection.

LPA and licensee toured the home and observed the following:

1. There were 10 children present under the care of 2 staff correcting the deficiency on Staffing Ration and Capacity 102416.5(e)
2. Four infants were observed in appropriate equipment: three were seated in high chairs being fed, while one is playing/crawling in a secluded area.
3. Licensee and assistant assured that no loose article will be placed in the playpen while infants are napping.
4. The disaster plan was provided and posted at the FCCH
5. An updated facility sketch, including measurements and labeling of accessible and inaccessible areas, was posted and provided to CCL on 10/8/2024
6.The fire and disaster drill journal was reviewed and found to be updated.
7. It was confirmed that licensee and assistant completed the Mandated Reporter Training on 10/8/2024.
Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/08/2024
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: SALGUERO FAMILY CHILD CARE
FACILITY NUMBER: 406216263
VISIT DATE: 10/08/2024
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8. The additional room in the garage, previously observed as occupied , is no longer in use.
9. The off limit room at the back of the home is vacated.

LPA noted that all the deficiencies cited during the precious inspection have been addressed; however, the assistant's except or the Assistant's immunization is pending which is scheduled for the immunization on 10/26/2024.
Also the Evaluation Report dated 9/27/2024 has been posted o the wall as required, and provided to the parents, and was acknowledged on LIC 9224 form.

Licensee submitted a new application form LIC 279 and Facility Sketch (LIC 999A) to include the back room as part of the day care area. LPA advise Licensee that Fries Safety inspection will also be conducted prior to occupancy of the back room.

No deficiencies during today's inspection

Report was reviewed and exit interview was conducted with licensee, Irma Salguero.

Inspection and report review was conducted in Spanish with the use Focus, and the translation application platform.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2024
LIC809 (FAS) - (06/04)
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