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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214357
Report Date: 03/06/2025
Date Signed: 03/06/2025 12:02:57 PM

Document Has Been Signed on 03/06/2025 12:02 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:PEREZ FAMILY CHILD CAREFACILITY NUMBER:
426214357
ADMINISTRATOR/
DIRECTOR:		MARIA PEREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 714-3214
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 9DATE:
03/06/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:35 AM
MET WITH:Maria Perez TIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On March 6, 2025 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 Maria Perez and informed them the purpose of the inspection. At the time of the inspection 9 children and 1 assistant were present.

LPA in the company of the licensee toured the interior of the FCCH. LPA notes the home's living room, dining area and 1 bathroom are used for child care purposes while the remainder of the home is excluded from care. LPA observed the living room and dining area to be clean and free of hazards. LPA observed the home to have a fire place that is inaccessible to children in care. LPA observed the children's areas to have sufficient age appropriate equipment for children in care. LPA observed the kitchen is accessible and that all cabinets and drawers are secured with child proof locks. LPA observed sharps and medication to be stored in an elevated kitchen cabinet that is beyond the reach of children. LPA did not observe any cleaning compounds in the accessible area of the home. Licensee informed LPA the cleaning compounds are stored in the locked laundry room. LPA observed the upstairs to be made inaccessible with a child gate that is located at the bottom of the stairs. LPA observed the bathroom for children to be clean and free of hazards.

LPA observed the backyard to be completely enclosed. LPA observed sufficient space for children's activities. LPA observed the backyard to have plenty of children's equipment in good condition. LPA reminded licensee to remove or replace damaged equipment. LPA observed a storage shed that is secured with a lock. LPA observed the sides of the home to be inaccessible to children. LPA did not observe any bodies of water on site.

The FCCH has a smoke and carbon monoxide detector which were tested at 10:03AM and found in working order. LPA observed the FCCH to have a regulation fire extinguisher which was purchased on 4/5/2024. 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: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/06/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 426214357
VISIT DATE: 03/06/2025
NARRATIVE
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LPA reviewed children's records which were found to be complete. LPA observed Safe Sleep 15 - minute checks for the infant to be current (last entry 3/6/2025). LPA observed licensee's Pediatric CPR/First Aid to be completed 7/19/23 and Mandated Reporter 7/29/25 to be completed on LPA reminded licensee the responsibility to have current training and certificates. The last emergency drill was conducted on 2/28/2025. Licensee stated there are not fire arms in the home.

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/.

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.


CONTINUED PAGE 3
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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: PEREZ FAMILY CHILD CARE
FACILITY NUMBER: 426214357
VISIT DATE: 03/06/2025
NARRATIVE
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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.

No deficiencies were issued during today's inspection.

Exit interview was conducted with licensee Maria Perez and Notice of Site visit was given.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC809 (FAS) - (06/04)
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