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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216616
Report Date: 06/28/2024
Date Signed: 06/28/2024 02:41:06 PM

Document Has Been Signed on 06/28/2024 02:41 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:VARGAS FCC AKA PLAY TO LEARN DAYCAREFACILITY NUMBER:
406216616
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
06/28/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:55 PM
MET WITH:Martha VargasTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On 6/28/24, at 1:55 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management/Change of Capacity inspection at the above referenced Family Child Care Home (FCCH). LPA met with Martha Vargas, Licensee of the FCCH and explained the nature/purpose of the inspection. It should be noted the Licensee's Assistant/ Spouse Juno Vargas assisted with communication/translation between LPA and Licensee, as the Licensee is primarily Spanish speaking. At the time of the inspection, LPA observed three children (two biological) on site.

LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. LPA observed the FCCH's interior and exterior to be clean and orderly. Moreover,the FCCH is free of hazardous materials and/or toxins.

LPA reviewed the Licensee’s First Aid/CPR certification (EMSA approved) which was found to be current (3/10/23) until 3/10/25. Further, LPA reviewed the Licensee’s Mandated Reporter Training certification which was found to be current (7/31/23) until 7/31/25. LPA observed a regulation fire extinguisher on site which was last purchased on 5/20/24. The FCCH's has a combination smoke/carbon monoxide detector which was tested at 2:10 PM and found to be operable.

Licensee submitted documentation for a FCCH change of capacity to the Department on in May of 2024. In essence, the Licensee is seeking to change the FCCH’s capacity from eight (Small FCCH) to fourteen (Large FCCH). On 6/25/24, the Department received a fire inspection clearance form from Cal Fire for a capacity of fourteen.

The FCCH meets Title 22, Division 12, of Community Care Licensing requirements for a Large FCCH License effective today, 6/28/24.

No deficiency were cited during todays inspection. LPA provided the Licensee a Notice of Site Visit (LIC 9213) as well as Appeal Rights (LIC 9058) . Licensee was informed the Notice of Site Visit must be posted for 30 days or a civil penalty of $100 may apply.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 06/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/28/2024
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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