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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426211262
Report Date: 12/05/2024
Date Signed: 12/05/2024 12:29:15 PM

Document Has Been Signed on 12/05/2024 12:29 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GUTIERREZ FCC AKA CARITAS FELICES DAYCAREFACILITY NUMBER:
426211262
ADMINISTRATOR/
DIRECTOR:		ANA MARIA GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 922-8316
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
12/05/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Ana Maria Gutierrez TIME VISIT/
INSPECTION COMPLETED:
12:43 PM
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On December 5, 2024 Licensing Program Analyst (LPA) Giovani Gonzalez conducted an unannounced Required 3 - Year inspection at the above-mentioned Family Child Care Home (FCCH). LPA met with licensee Ana Maria Gutierrez and informed them the purpose of the inspection. At the time of the inspection 2 children and 2 assistants were present.

LPA in the company of the licensee toured the interior end exterior of the FCCH. LPA observed the living room to be free of hazards and to have sufficient ventilation for children in care. LPA observed the fire place to be cover and inaccessible to children in care. LPA observed the wall heater to be covered as well. LPA observed the kitchen to be accessible to children. LPA notes all lower drawers and cabinets were free of hazards and had child proof locks. LPA observed cleaning compounds, sharps, and medication to be stored in an elevated kitchen cabinet, beyond the reach of children in care. LPA observed the door to the garage to be secured with a child proof lock. LPA observed bedrooms to be secured with child proof locks. LPA observed the bathroom used for children in care to be clean and free of hazards.

LPA observed the front patio to be completely enclosed. LPA observed sufficient shading and equipment for children in care. LPA observed various storage containers with children's toys and equipment. LPA reminded licensee to ensure cleaning products are put away prior to children being outside. LPA observed the exit/entry way to be secured with a latch.

The FCCH has a combination smoke and carbon monoxide detector which was tested at 10:21 AM and found in working order. LPA observed the FCCH to have a regulation fire extinguisher which was serviced on 5/20/2024. LPA reminded Licensee to either service or purchase a regulation fire extinguisher annually.


CONTINUED PAGE 2
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2024
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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Document Has Been Signed on 12/05/2024 12:29 PM - It Cannot Be Edited


Created By: Giovani Gonzalez On 12/05/2024 at 11:28 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUTIERREZ FCC AKA CARITAS FELICES DAYCARE
FACILITY NUMBER: 426211262

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/05/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 2 out of 3 adults not having a current Mandated Reporter Training Certificate which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/12/2024
Plan of Correction
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Licensee will have assistants complete the Mandated Reporter Training by 12/12/24. Licensee will provide proof of completion to LPA via email at giovani.gonzalez@dss.ca.gov.
Type B
Section Cited
HSC
1597.622(c)
Administration of Child Day Care Licensing
(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above in 2 out 3 adults not having documentation of immunization against pertussis which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 12/12/2024
Plan of Correction
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Licensee will submit documentation of assistants' immunization against pertussis. Licensee will provide proof of immunization to LPA via email at giovani.gonzalez@dss.ca.gov.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:
DATE: 12/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/05/2024


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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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUTIERREZ FCC AKA CARITAS FELICES DAYCARE
FACILITY NUMBER: 426211262
VISIT DATE: 12/05/2024
NARRATIVE
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LPA reviewed a sampling of children's files which were found to be current and complete. LPA notes licensee is not currently caring for infants. LPA reviewed assistants files. LPA observed both assistants to not have a current Mandated Reporter Training certificate. Further, LPA observed both assistant files to be missing proof of pertussis immunization. 2 Type B deficiencies are being issued as a result. LPA observed licensee's Mandated Reporter(completed (6/5/2024) and CPR/First Aid (completed 4/30/23) to be current. LPA reminded licensee it is their responsibility to have current certifications and training.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.
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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUTIERREZ FCC AKA CARITAS FELICES DAYCARE
FACILITY NUMBER: 426211262
VISIT DATE: 12/05/2024
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

2 Type B deficiencies were issued during today's inspection.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Ana Maria Gutierrez. Appeal Rights were given.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC809 (FAS) - (06/04)
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