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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216445
Report Date: 10/20/2022
Date Signed: 10/20/2022 09:54:11 AM

Document Has Been Signed on 10/20/2022 09:54 AM - 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:VILLA FCC AKA AMORES FRIENDS CHILDCAREFACILITY NUMBER:
406216445
ADMINISTRATOR:HAYDEE VILLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 714-9559
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/20/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:53 AM
MET WITH:Haydee VillaTIME COMPLETED:
10:09 AM
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This is a change of location inspection, previous facility number 406214955.

On October 20, 2022 at 8:57 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an announced prelicensing inspection. LPA met with licensee Haydee Villa 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.

Licensee has a four (4) bedroom two (2) and half (1/2) bathroom single floor home. The licensee will be using one (1) bedroom, the living room, one (1) restroom, one (1) half (1/2) restroom, and the backyard for children in care. The other three bedrooms, front yard, and garage will be off limits to children in care. LPA observed chain locks on all the off limit bedrooms and a gate in the hallway preventing children from entering the area. LPA observed a 2A10BC fire extinguisher mounted on the wall in the kitchen readily accessible. Licensee had safety locks on the kitchen cabinets preventing children from having access. The living room is openly spaced with a couch and dining table. The bedroom being used for care has toys, activities, and furniture readily accessible for the children. A sliding glass door to the backyard is located in the day care room. LPA observed a fence in the backyard separating the children's outdoor yard from the other yard. Children will be escorted through off-limits yard to the their yard. The children's yard is enclosed with a wooden fence. LPA observed age appropriate play structures, toys, and tables available for the children to use. Licensee used sand/pea gravel to create a soft ground for the children in the yard. LPA discussed state required forms and Safe Sleep requirements with licensee.

No deficiencies cited during inspection. License to operate a Large Family Child Care facility is effective today 10/20/22.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/20/2022
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: VILLA FCC AKA AMORES FRIENDS CHILDCARE
FACILITY NUMBER: 406216445
VISIT DATE: 10/20/2022
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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

Exit interview conducted and report was reviewed with the licensee

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: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC809 (FAS) - (06/04)
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