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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426209361
Report Date: 12/06/2023
Date Signed: 01/16/2024 01:13:00 PM

Document Has Been Signed on 01/16/2024 01:13 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:PULIDO FAMILY CHILD CAREFACILITY NUMBER:
426209361
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
12/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Irene PulidoTIME COMPLETED:
12:15 PM
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This amended report supplements the original report dated 12/6/2023 to incorporate the discussion on safe sleep regulation information on criminal record clearance, Megan's law and incidental medical services.

On December 6, 2023, at 11:00 AM, Licensing Program Analyst, (LPA) Gigi Reyes conducted an unannounced Case Management inspection for a change of capacity. During the inspection, the Licensing Program Analyst (LPA) met with Licensee, Irene Pulido and explained the purpose and scope of the visit. No children were observed during the inspection.

LPA and Licensee toured the interior and exterior of the home. LPA observed that both the interior and exterior specifically the day care area were free of hazardous materials and/or toxins at the time of the inspection. LPA reviewed Licensee's file, First Aid/CPR certification was verified which will expire on 10/21/2025. Fire Extinguisher was purchased on 4/3/2023. Licensee's Mandated Reporter Training was completed on 4/18/2022 which expires in 2024 of the same month.


On August 22, 2023, License submitted an application for a change of capacity. The proposed change is to increase the Family Child Care Home's (FCCH) capacity from 8 to 14. Fire clearance was granted on August 29, 2023.

No concerns were identified during the inspection. Large FCCH License is granted effective today 12/6/2023. Change of capacity approval was based on the compliance observed during the inspection.

Notice of site visit was issued and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Irene Pulido.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 11/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/12/2023
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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