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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215922
Report Date: 01/30/2025
Date Signed: 01/30/2025 11:37:47 AM

Document Has Been Signed on 01/30/2025 11:37 AM - 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/
DIRECTOR:		ELIZABETH REYS PINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 868-5753
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/30/2025
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Elizabeth Reyes Pina
and Hilda Pina Hernandez 		TIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On January 30, 2025, at 9:00 AM, Licensing Program Analyst (LPA) Gigi Reyes \ conducted an unannounced Annual Random inspection at the above Family Childcare Home (FCCH). LPA met with Licensee’s assistant, Hilda Pina Hernandez. Licensee, Elizabeth Reyes Pina, arrived 15 minutes later. LPA discussed the purpose of the inspection. The FCCH operates Monday to Friday from 5:00 AM to 6:00 PM, Saturday, 5:00 AM to 2:00 PM. FCCH provides care to children age 3 months to 12 years old.

During the inspection, LPA and Assistant toured the inside and outside of the home. LPA observed 2 children, additional child was dropped off during the inspection.
The required licensing forms were posted at the entrance hallway visible to all parents and authorized representative. FCCH was free of hazardous items at the time of the inspection. FCCH utilizes living room, 1 bedroom, 1 bathroom, dining, and the backyard for day care operation.

Licensee tested the carbon monoxide and smoke detectors and found functional. The regulation fire extinguisher was serviced on 4/2/2024. Aged-appropriate toys, and equipment were observed inside the home. The backyard is completely fenced and equipped with age appropriate toys and equipment.
Continued on LIC 809C.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/30/2025
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: REYES PINA FCC REYES DAY CARE
FACILITY NUMBER: 426215922
VISIT DATE: 01/30/2025
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LPA did not observe any bodies of water. Licensee stated there are no guns or ammunition in the home. Fire and disaster drill is conducted every 3 months, the last drill was conducted on November 18, 2024.
LPA reviewed the facility file and found that the Pediatric CPR and First Aid certificate expires on 4/27/2026. It is noted that Assistant, Hilda Pina Hernandez has a current Pediatric CPR and First Aid as well. All staff have renewed the Mandated Reporter Training and certificate expires on 7/12/2026. LPA reminded Licensee of the said certificates to be renewed every two years.

LPA reviewed children’s files and found complete. There is an Individual Safe Sleep Plan for infant 0 to 12 months on each child’s file. Licensee and Assistant check and documents napping infants every months.

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.

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.

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.

Continued LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: REYES PINA FCC REYES DAY CARE
FACILITY NUMBER: 426215922
VISIT DATE: 01/30/2025
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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 Elizabeth Pina Hernandez 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, Elizabeth Pina Hernandez, 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/.

Continued LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: REYES PINA FCC REYES DAY CARE
FACILITY NUMBER: 426215922
VISIT DATE: 01/30/2025
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During the exit interview, the LICENSEE, Elizabeth Pina Hernandez confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

In the areas evaluated, there were no deficiencies cited.



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, Elizabeth Reyes Pina.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
LIC809 (FAS) - (06/04)
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