426216216-12-9-2021-17-CC-FVEZ-C9JU4S-20211209141537

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216216
Report Date: 12/09/2021
Date Signed: 12/09/2021 02:15:42 PM

Document Has Been Signed on 12/09/2021 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:	RUIZ FAMILY CHILD CARE		FACILITY NUMBER:	426216216
ADMINISTRATOR:	ADELA RUIZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 260-6048
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	12/09/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Adela Ruiz		TIME COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 12/9/21, at 12:30 PM, Licensing Program Analyst (LPA) Francisca Velazquez made an announced Pre-licensing Inspection of the abovementioned home. LPA met with Adela Ruiz, the Applicant of the home and explained the purpose of the inspection. Applicant informed LPA of intention to operate a Large Family Child Care Home, when licensed, from Monday to Sunday for 24-hour care. LPA observed no children on site during the inspection. LPA toured the interior and exterior of the home with the Applicant. The home is a four-bedroom, three bath, two story dwelling. Applicant stated the one of the home’s living room, dining room, hallway bathroom and backyard will be used for child care, while all the rooms on the second floor, garage and laundry room and part of the outdoor yard will be excluded from child care services. LPA notes children in care will access the bathroom while passing through the home’s laundry room. LPA observed a safety gate located on the bottom steps of the home making the second floor inaccessible to children in care. LPA observed child safety gates at the entrance of the kitchen making the kitchen inaccessible to children in care. LPA observed the home to be clean and orderly. LPA observed two fireplaces in the home. Both fireplace in the home’s living rooms are secured and screened and made inaccessible to children in care. The bathroom to be used for children care is observed to be clean and free of toxins with hand washing poster for children. Medication in the home is located in an elevated cabinet in the kitchen which is in an excluded area of care. Detergents and cleaning compounds are stored in a high cabinet in the home's laundry room which is inaccessible to children in care and in an excluded area. LPA observed carbon monoxide and smoke detectors in the home which were found to be operable. Each detector was tested at 1 PM. The home has appropriate heating and ventilation. LPA observed a regulation fire extinguisher on site which was purchased on 6/17/21. LPA reminded the Applicant to purchase or service a regulation fire extinguisher annually. The Applicant informed LPA no firearm or ammunition is on site. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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: RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426216216
	VISIT DATE: 12/09/2021

NARRATIVE

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The backyard is enclosed by wooden fencing and the footing is made up a concrete slab. The backyard is divided into two yards. Applicant stated that children will only have access to one part of the yard. LPA observed a shed containing outdoor play equipment for children. The area entry/exit gates are secured. The backyards are free of hazards. LPA observed bodies of water are on site. Bodies of water are located in the backyard that is inaccessible to children in care. LPA observed the floor jacuzzi to be covered and locked with four locks making the jacuzzi inaccessible to children in care. LPA observed the below ground pool to be gated with a fence that is more than 5 feet high and has a lock on the door ensuring the pool is inaccessible to children in care .

The Applicant completed Preventative Health training on 2/24/18. Further, the Applicant completed Mandated Reporter training on 8/7/20. The Applicant’s Pediatric CPR and First Aid certificates expire on 2/28/22 (EMSA approved). LPA reviewed Applicant's control of property documents. Applicant does not have liability insurance at this time. LPA informed Applicant to ensure parents sign a waiver for the liability insurance. Applicant was provided LIC 282 form. Applicant was granted fire clearance from Santa Maria Fire Department on 11/12/21.

LPA reviewed overnight care with applicant and left CCR 102426 for Applicant to review further.

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

CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

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: RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426216216
	VISIT DATE: 12/09/2021

NARRATIVE

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LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep
as an additional resource. LPA also informed applicant 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. Applicant was informed baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours.

Applicant 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 AB 633 and provided Pre-licensing packet to Applicant. LPA reviewed and issued the Applicant updated samples of state required forms to be kept in the children's record. LPA also discussed the effects of Lead Exposure leaflets as well as literature related to COVID 19 safeguards and best practices (RAST TA visit completed).

Applicant was made aware that it is Applicant's responsibility to know the regulations for Family Child Care Home (FCCH) which can be accessed on-line at www.ccld.ca.gov.

The home meets the requirement for a Large FCCH. License to operate a FCCH is effective today, 12/9/21.

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.

This inspection and review of report was conducted in Spanish due to Spanish being Applicant primary language.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021

LIC809 (FAS) - (06/04)

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