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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215950
Report Date: 01/18/2023
Date Signed: 01/18/2023 02:15:31 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 01/18/2023 02:15 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:HUITZ FAMILY CHILD CAREFACILITY NUMBER:
426215950
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
01/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Estrella HuitzTIME COMPLETED:
02:10 PM
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On January 18th, 2023, at 12:20PM Licensing Program Analyst (LPA) Rosie Breault made an unannounced Annual/Random inspection. LPA met with licensee Estrella Ruiz and advised of nature and purpose of inspection. Additionally, licensee submitted a request for increase of capacity which will be addressed during the inspection. In addition to licensee, was her daughter Bibiana (over aged 18, and assistant) was present and is fingerprint cleared. At the time of the inspection there were four (4) children present and 2 staff. Licensee provided LPA a tour of the facility both inside and out.

This is a three (3) bedroom, two (2) bathroom, single story home. Off limit areas are identified as one bathroom, all three bedrooms, kitchen, and dining room. On limit areas are identified as playroom, living room, and sunroom, back yard play area, and children use one bathroom hallway for toileting needs. Licensee has required documents posted in a prominent place. Smoke and carbon monoxide detectors were tested and functioning at the time of the inspection. Facility has current fire extinguisher with service date of 10/18/2022. Licensee stated no firearms or ammunition present in the home. LPA observed age-appropriate toys, fixtures and play equipment for children in use. Back yard has perimeter fencing and age-appropriate toys. No bodies of water are present.

During the course of the inspection, the kitchen was not gated and accessible to children in care. At the edge of the counter there was a large kitchen knife with handle facing outward on the counter and within reach of children. This is a violation of Title 22 Division 12 102417 (g) (h) and a Type A violation will be cited. In the living room (rear of the house), LPA observed a wall heater that is not covered or protected, accessible to children in care. This is a violation of Title 22 Division 12 (g) (1) and a Type B violation will be cited.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/18/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 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: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950
VISIT DATE: 01/18/2023
NARRATIVE
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LPA observed current facility roster, verification of emergency drill last conducted on August 15th, 2022. A sampling of children and staff records was conducted. LPA reviewed current Infant Needs and Services Plan and sleep logs. LPA observed assistant was current on Adult and Pediatric CPR expiring 12/6/2024. Mandated Reporter current through 8/6/2023. Licensee states no incidental medical services are being used. Children files were found to be current and complete.

The home was cleared by Lompoc Fire Marshal on 12/28/2022 stating all safety precautions have been put into place and areas of care and supervision are confined to only: living room, sunroom, and playroom.

Family Child Care Home (FCCH) meets the requirements for a large FCCH effective today 1/18/2023 and capacity has been increased to 14.

Deficiencies cited on today’s inspection will be on the attached LIC809D

Exit interview was conducted with licensee, report provided, LIC9224, and appeal rights provided.

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: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 01/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 01/18/2023 02:15 PM - It Cannot Be Edited


Created By: Maryrose Breault On 01/18/2023 at 01:51 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/18/2023
Section Cited
CCR
102417(g)(4)

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Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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Licensee is to provide photographic proof of all knives and sharp instruments locked in cabinets and / or stored inaccessible to children to LPA via email by 1/27/2023. Licensee to email: maryrose.breault@dss.ca.gov
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This is evidenced by....
LPA observed one large kitchen knife on countertop accessible to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Maryrose Breault
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 01/18/2023 02:15 PM - It Cannot Be Edited


Created By: Maryrose Breault On 01/18/2023 at 01:54 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/18/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/18/2023
Section Cited
CCR
102417(g)(1)

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Fireplaces and open-face heaters shall be screened to prevent access by children.
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Licensee to provide reciept of purchase of wall heater cover and photographic evidence that heater is covered in a manner that ensures safety and is not a fire hazard by 1/27/2023 to maryrose.breault@dss.ca.gov
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This evidence is met by:

LPA observed one large wall heater accessible to children in the living room.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Maryrose Breault
LICENSING EVALUATOR SIGNATURE:
DATE: 01/18/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/18/2023


LIC809 (FAS) - (06/04)
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