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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215906
Report Date: 04/21/2023
Date Signed: 06/07/2023 04:20:26 PM

Document Has Been Signed on 06/07/2023 04:20 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:ZEPEDA FCC AKA TINY CHILDREN'S CAREFACILITY NUMBER:
426215906
ADMINISTRATOR:LUPE ZEPEDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 363-0964
CITY:GUADALUPESTATE: CAZIP CODE:
93434
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
04/21/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Lupe ZepedaTIME COMPLETED:
12:45 PM
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On 04/21/2023 at 9:45 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced One Year Required Inspection of the Family Child Care Home (FCCH). LPA met with Lupe Zepeda, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of Licensee toured the interior and exterior of the FCCH. LPA notes five (5) children are present being cared by Licensee and Alondra Serafin, assistant of the licensee.

This is a single-story home with two bedrooms (2) bedrooms, two (2) bathrooms, living room, dining room, kitchen, garage, family living room that has been converted to a bedroom and outdoor yard. The daycare services occur in the living room, dining area, bathroom, and outdoor yard. Meanwhile, the kitchen, two (2) bedrooms, one (1) bathroom, garage, and family living room that has been converted to a bedroom are inaccessible to children in care. LPA observed a baby gate making the kitchen, family living room that has been converted to a bedroom and garage inaccessible to children in care. Additionally, LPA observed another baby gate making two (2) bedrooms inaccessible to children in care.

LPA observed the home to be clean and orderly. There is plenty of ventilation to afford the children comfort. LPA observed an open face heater in the living room that is secured by means of a small gate. LPA observed sharps and medications for the family are stored in elevated cabinets in the kitchen that are locked. LPA observed cleaning compounds are stored in the garage. LPA notes all these areas are inaccessible to children in care. The restroom that is used for childcare services is clean and free of toxins. In the FCCH, LPA observed toys, furniture, and equipment are in good conditions and are age appropriate for the children in care.

Required forms are predominantly posted on the wall of the living room. LPA observed a smoke and carbon monoxide detectors in the FCCH that were tested at 10:05 AM and were operable during this inspection. LPA observed the home has a regulation fire extinguisher that was purchased on 3/15/23. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/21/2023
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: ZEPEDA FCC AKA TINY CHILDREN'S CARE
FACILITY NUMBER: 426215906
VISIT DATE: 04/21/2023
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 LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services. Licensee informed LPA no guns or ammo are stored in the FCCH.

LPA observed the outdoor yard to be completely fenced. LPA observed the exit doors to be secured. LPA observed that a section of the outdoor yard is made inaccessible to children by means of a baby gate. The outdoor yard provides plenty of shading for the children in care. LPA observed two sheds in the outdoor yard that are locked and inaccessible to children in care. LPA observed the yard to have plenty of shading for children in care. Filtered drinking water is provided by means of individual cups that are labeled with the name of children. Toys, furniture, and equipment observed in the outdoor yard are age appropriate and in good conditions. No bodies of water are observed.

LPA reviewed Licensee, assistant and children's records. The children’s records were complete and found to contain emergency contact information as well as immunization records. LPA reviewed 15 minute sleep logs for all infants in the FCCH. In addition, all children present during today’s inspection are documented in the facility roster. LPA reviewed Licensee’s Pediatric First -aid certificate that is valid until 01/19/2025 and Licensee's Mandated Reporter training certification expires 02/20/2024. Assistant file review found Pediatric First -aid certificate that is valid until 3/24/2024 and Mandated Reporter training certification expires 03/30/2024. The last emergency drill was conducted and documented on 04/20/2023.

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.

CONT 809-C

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

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
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: ZEPEDA FCC AKA TINY CHILDREN'S CARE
FACILITY NUMBER: 426215906
VISIT DATE: 04/21/2023
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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 for 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.

No deficiencies cited 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, Lupe Zepeda.

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

DATE: 04/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2023
LIC809 (FAS) - (06/04)
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