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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215505
Report Date: 08/05/2021
Date Signed: 08/05/2021 02:49:58 PM

Document Has Been Signed on 08/05/2021 02:49 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:MEZA-LOZANO FAMILY CHILD CAREFACILITY NUMBER:
426215505
ADMINISTRATOR:MARIA MEZA & R. LOZANOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 623-2962
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
08/05/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:10 PM
MET WITH:Maria MezaTIME COMPLETED:
03:00 PM
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On 8/5/21, at 1:10 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted a Required Inspection of the facility. Prior to entering the facility, LPA completed COVID-19 pre-screening questionnaire with Licensee and based on Licensee's responses it was determined that facility did not have COVID-19 exposures. LPA met with Maria Meza and Rodolfo Lozano, Licensees' of the facility and explained the purpose of the inspection. LPA, in the company of the Licensee Maria, toured the interior and exterior of the facility. This home consists of two (2) bedrooms, three (3) bathrooms, living room, kitchen, dining room, laundry room, backyard. Licensee stated that children have access to the first floor of the home which consists of the living room, kitchen, dining area, bathroom and backyard, while the second floor and laundry room are inaccessible to children in care. At the time of the inspection seven (7) children are present.

The home was orderly and clean with proper ventilation for all children in care. The bathroom used for care are clean and has hand washing poster for the children. All cabinets in the bathrooms are locked with safety latches and are inaccessible to the children in care. LPA observed a fire place in the living room that is covered and made inaccessible to children. LPA observed that all kitchen cabinets have safety latches making them inaccessible to children in care. LPA observed that sharps and knives are stored on top of the refrigerator and inaccessible to children in care. Licensee’s medications are stored in the kitchen on a high cabinet that is locked and inaccessible to children in care. LPA observed that cleaning compounds are stored under the sink of the bathroom and in a high cabinet in the kitchen and both areas are inaccessible to children in care. Toys, furniture and equipment in the facility are age appropriate.

LPA observed required licensing forms post by the entrance of the facility. LPA observed smoke and carbon monoxide detector located on the ceiling of the living room. Both detectors were tested and found to be operational at 1:35 PM. LPA observed a regulation fire extinguisher that was serviced 6/27/21. LPA reminded Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log. The most recent fire drill conducted and documented was today. LPA reminded Licensee that emergency drills must be conducted and documented every 6 months. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/05/2021
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: MEZA-LOZANO FAMILY CHILD CARE
FACILITY NUMBER: 426215505
VISIT DATE: 08/05/2021
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LPA observed that the backyard is completely fenced. LPA observed plenty of gross motor activities and shade for the children in care. Toys and play equipment observed in backyard are age appropriate and in good conditions. LPA observed the laundry room has an extra safety latch to ensure children do not have access to the laundry room. LPA observed no bodies of water on site.

Licensee informed LPA no firearms or ammunition are stored on site.

LPA reviewed a sampling of the children records. All records reviewed are current and contains complete emergency card information. Facilities current roster of children was reviewed by the LPA during inspection. All children present during the inspection are noted in the roster. LPA reviewed the Licensees' Pediatric CPR and First Aid certifications which both expire 3/23/23. Licensees' do not have AB1207 Mandated Reported Training Certificate. Licensees' agree to complete AB1207 Mandated Reporter Training Certificate. LPA provided Licensees' with training information to complete AB1207.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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: www.ada.gov/childqanda.htm

LPA discussed COVID 19 guidance and best practices with the Licensee. LPA discussed safe sleep regulations with the Licensee. Licensee was provided with a copy of the Safe Sleep Regulations and Individualized Infant Sleep Plan. Licensee was reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.



In areas evaluated, there were no deficiencies cited at this time.

Today's inspection and review of report was conducted in Spanish due to Licensee being primarily Spanish speaking.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
LIC809 (FAS) - (06/04)
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