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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216003
Report Date: 03/20/2023
Date Signed: 03/20/2023 08:12:11 PM

Document Has Been Signed on 03/20/2023 08:12 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:NORIEGA FAMILY CHILD CAREFACILITY NUMBER:
426216003
ADMINISTRATOR:CRISTINA N NORIEGAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 922-6313
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 4DATE:
03/20/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Cristina NoriegaTIME COMPLETED:
12:30 PM
NARRATIVE
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On March 20, 2023 at 10:00 AM, Licensing Program Analysts (LPAs) Francisca Velazquez and Dixie Wright conducted an unannounced One Year Required Inspection of the Family Child Care Home (FCCH). LPAs met with Cristina Noriega, 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 four (4) children are present being cared by Licensee.

This is a single-story home with three (3) bedrooms and two (2) bathrooms, living room, dining room, kitchen, garage, and outdoor yard. The daycare services occur in the living room, dining area, bathroom, and outdoor yard. Meanwhile, three (3) bedrooms, one (1) bathroom, and garage are off-limits and not accessible to children in care. LPAs observed door safety knobs on three (3) bedroom doors, one (1) bathroom door and garage, making these areas inaccessible.

LPAs observed the home to be clean and orderly. There is plenty of ventilation to afford the children comfort. LPAs observed two (2) open face heaters that are covered and inaccessible to children in care. In the kitchen, LPAs observed sharps are stored in an elevated cabinet that is locked. LPAs observed medication for the family is stored in a separated elevated cabinet in the kitchen that is also locked. LPAs observed cleaning compounds in the garage, elevated cabinet in the kitchen and in a locked cabinet located in the hallway. LPAs note all these areas are inaccessible to children in care. The restroom that is used for childcare services is clean and free of toxins. LPAs observed toys, furniture, and equipment within the FCCH are age appropriate.

LPAs observed the outdoor yard is completely fenced. There is one shed in the outdoor yard that is locked an inaccessible to children in care. LPAs observed the exit doors to be secured. The outdoor yard provides plenty of natural shading for the children in care. Drinking water is provided by means of individual cups. Toys, furniture, and equipment observed in the outdoor yard are age appropriate and in good conditions.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 03/20/2023 08:12 PM - It Cannot Be Edited


Created By: Francisca Velazquez On 03/20/2023 at 11:49 AM
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: NORIEGA FAMILY CHILD CARE
FACILITY NUMBER: 426216003

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(D)(c)
Infant Safe Sleep
Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in that Licensee is not documenting 15 minute checks for infants which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/27/2023
Plan of Correction
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Licensee agrees to start doucumenting 15 minute checks for all infants in the FCCH and will submit proof via email to Francisca.Velazquez@dss.ca.gov by 3/27/23.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Maria Mueller
LICENSING EVALUATOR NAME:Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2023


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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: NORIEGA FAMILY CHILD CARE
FACILITY NUMBER: 426216003
VISIT DATE: 03/20/2023
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Required forms are predominantly posted in the living room. LPAs observed a smoke detector that was tested at 10:49 AM and was operable. Carbon monoxide detector was tested at 10:56 AM and was operable during this inspection. LPAs observed the home has a regulation fire extinguisher that was serviced on 10/17/22. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services. No bodies of water are observed.

LPAs reviewed Licensee and children's records. LPAs reviewed children files and found them to be complete and current. Licensee is not documenting infant sleep logs for children under the age of 2 years. Per Licensee, she checks on the infants but was not aware that 15 minute checks needed to be documented. Licensee reviewed infant safe sleep regulations and understands that 15 minute checks need to be documented. LPAs note 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 07/02/2024 and Licensee's Mandated Reporter training certification expires 08/16/2024. The last emergency drill was conducted and documented on 03/06/23. The Licensee informed LPAs there are no firearms and ammunition on site.

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.

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.

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

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
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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: NORIEGA FAMILY CHILD CARE
FACILITY NUMBER: 426216003
VISIT DATE: 03/20/2023
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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.

LPAs that prohibited items were observed in the living room of the facility. Licensee stated these items belong to her infant child. LPAs explained that these items can only be used outside of daycare hours and must be stored in off-limit areas of the home. LPAs did not observe any children using these items.

Type B deficiency is being cited.

A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Cristina Noriega.

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

DATE: 03/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023
LIC809 (FAS) - (06/04)
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