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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215922
Report Date: 07/18/2023
Date Signed: 07/18/2023 04:02:29 PM

Document Has Been Signed on 07/18/2023 04:02 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:REYES PINA FCC REYES DAY CAREFACILITY NUMBER:
426215922
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
07/18/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Elizabeth Reyes PinaTIME COMPLETED:
04:15 PM
NARRATIVE
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On 7/18/23 at 3:15 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Case Management- Change of Capacity inspection at the abovementioned Family Child Care Home (FCCH). LPA met with Elizabeth Reyes Pina, Licensee of the FCCH and explained the nature/purpose of the inspection. At the time of the inspection, LPA notes three children are in care.

LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. LPA observed the FCCH's interior and exterior to be free of hazardous materials and/or toxins which would pose a danger to the children in care.

LPA reviewed Licensee’s First Aid/CPR certification (EMSA approved) which was found to be current until 4/9/24. Further, LPA reviewed the Licensee’s Mandated Reporter Training certification which was found to be current until 3/23/24. LPA observed a regulation fire extinguisher which was last serviced on 4/5/23.

The Licensee submitted documentation for a FCCH change of capacity to the Department in March of 2023. In essence, the Licensee is seeking to change the FCCH’s capacity from eight (Small FCCH) to fourteen (Large FCCH). On 6/13/23, the Department received a fire inspection clearance form from the City of Santa Maria Fire Department for a capacity of fourteen. As such the FCCH's change of capacity to 14 is granted on the present, 7/18/23.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the Licensee Elizabeth Reyes Pina.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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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