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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215759
Report Date: 11/19/2024
Date Signed: 11/19/2024 04:13:58 PM

Document Has Been Signed on 11/19/2024 04:13 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:GUTIERREZ FAMILY CHILD CAREFACILITY NUMBER:
426215759
ADMINISTRATOR/
DIRECTOR:		NOHEMI GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 260-0281
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
11/19/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Nohemi GutierrezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On November 19, 2024, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Annual inspection at above Family Child Care Home (FCCH). LPA met with Nohemi Gutierrez, licensee. LPA discussed the purpose of the inspection and together LPA and licensee toured the inside and outside of the home.

FCCH operates from Monday to Saturday, from 5:00 AM to 6:00 PM. Licensee cares for children ages 0 to 12 years of age.

LPA observed, three (3) children in care at the time of the inspection. The required licensing forms were posted at the day care area. FCCH was free of hazardous items at the time of the inspection. FCCH utilizes living room, dining, kitchen, bathroom, and outdoor play area.

Bathroom for children’s use is free of toxins. Smoke and carbon monoxide detectors were tested at 2:37 PM and found functional at the time of the inspection. LPA observed a regulation fire extinguisher that was purchased on 06/14/2024. Age-appropriate toys, book, and equipment were observed. Licensee stated there are no guns nor ammunition in the home.

This Report Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/19/2024
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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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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 426215759
VISIT DATE: 11/19/2024
NARRATIVE
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LPA and licensee toured the outdoor play area. LPA observed the exits to be secured. LPA observed there is shading to afford the children in care. In addition, Filtered water will be accessible with individual water cups. The play area has age-appropriate toys and day-care equipment. LPA advised the licensee children must never be unsupervised while the children are at the play area.

· No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

LPA reviewed the facility file and that revealed Licensee's the Pediatric CPR and First Aid certificate expires on 03/26/2026. Licensee, Mandated Reporter Training expires on 12/07/2025. Children’s records were reviewed and found complete. Control of property was reviewed. FCCH conducts and logs the fire and disaster drills every 6 months, last drill was conducted on 09/26/2024.

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.

This Report Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 426215759
VISIT DATE: 11/19/2024
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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, Nohemi Gutierrez 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, 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.

Licensee is not providing Incidental Medical Services (IMS). 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/.

This Report Continues on LIC809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: GUTIERREZ FAMILY CHILD CARE
FACILITY NUMBER: 426215759
VISIT DATE: 11/19/2024
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Licensee, was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

On this date, 11/19/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility


addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

During today’s inspection no deficiency was cited. The inspection visit was conducted in Spanish and report was translated in Spanish by LPA Jimenez. A notice of site visit was given to licensee, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the licensee, Nohemi Gutierrez .
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2024
LIC809 (FAS) - (06/04)
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