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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214093
Report Date: 05/19/2022
Date Signed: 05/19/2022 12:10:43 PM

Document Has Been Signed on 05/19/2022 12:10 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:RIVERA FCC AKA ALECRIM DOURADOFACILITY NUMBER:
426214093
ADMINISTRATOR:PRISCILA C. RIVERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 714-2092
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
05/19/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Priscila C. RiveraTIME COMPLETED:
12:42 PM
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On 05/19/22, at 10:20 AM Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Priscila C. Rivera, Licensee of the FCCH and explained the nature and purpose of the inspection. Prior to entering the facility, LPA conducted COVID-19 questionarie and based on Licensee's responses it was determine that the facility is safe and free of any COVID-19 exposures. LPA notes nine (9) children are on site being cared by Licensee and two (2) assistants Maria Rangel Carneiro and Ary Carneiro.

LPA, in the company of the Licensee, toured the exterior and interior of the FCCH. Day care services are offered in the day care room. Children have access to the home’s living room for napping, day care room bathroom and outdoor yard are used for child care services, while the bedrooms, and garage are excluded from services. LPA notes that all bedroom doors and garage were locked and inaccessible to children in care.
The FCCH is orderly and has ventilation to afford for the children’s comfort and safety. The restroom used for childcare services is found to be clean and free to toxins. Medication in the FCCH is stored in an elevated cabinet in the hallway of the facility. Sharps are stored in an elevated cabinet in the kitchen. Cleaning compounds were observed to be stored in an elevated cabinet on top of the microwave and in the garage, both areas are inaccessible to children in care. Toys, furniture and equipment observed in the FCCH are age appropriate.

Required forms are posted on the FCCH daycare room wall. The FCCH has smoke and carbon monoxide detectors which were tested at 11:05 am and found to be operable. The FCCH has a regulation fire extinguisher that was purchased on 01/11/2022. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill documentation. The last drill was completed on 5/12/22. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 05/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/19/2022
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: RIVERA FCC AKA ALECRIM DOURADO
FACILITY NUMBER: 426214093
VISIT DATE: 05/19/2022
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The outdoor play yard is completed fenced. LPA notes that the yard affords plenty of shade for the children. Licensee ensures filtered water is accessible to children by means of water jugs and disposable cups. Toys, furniture and equipment observed in the yard are age appropriate. LPA observed no bodies of water on site.

A sampling of the children's records were reviewed. The records are current, complete and possessed emergency contact information. The Licensee's records were also reviewed and found to be complete. Licensee’s Pediatric CPR and First (EMSA approved) is valid until 10/16/22 and Mandated Reporter certificate is valid until 10/19/22. LPA also reviewed staff files for both assistants present during inspection. LPA found assistant, Maria R. Carneiro records are current with Pediatric CPR and First (EMSA approved) expiring on 12/14/23 and Mandated Reporter certificate expiring on 10/20/23. LPA found assistant, Ary Carneiro records are current with Pediatric CPR and First (EMSA approved) expiring on 8/21/23 and Mandated Reporter certificate expiring on 8/13/23.



The Licensee notes no firearms or ammunition are stored on site.

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.htm

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/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 [facility representative] 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. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2022
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: RIVERA FCC AKA ALECRIM DOURADO
FACILITY NUMBER: 426214093
VISIT DATE: 05/19/2022
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During today's inspection, no deficiencies are being cited. A notice of site visit was given and must remain posted for 30 days.

Exit interview and report was reviewed with the licensee, Priscila Rivera.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2022
LIC809 (FAS) - (06/04)
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