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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216327
Report Date: 06/21/2022
Date Signed: 06/21/2022 04:56:29 PM

Document Has Been Signed on 06/21/2022 04:56 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:MURGUIA FAMILY CHILD CAREFACILITY NUMBER:
426216327
ADMINISTRATOR:PIEDAD MURGUIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 714-6244
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/21/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Piedad MurguiaTIME COMPLETED:
05:00 PM
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On 06/21/22, at 1:30 PM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced Prelicensing Inspection of the abovementioned home and met with Applicant, Piedad Murguia. LPA informed Applicant of the nature and purpose of the inspection. LPA notes there are no children on site at the time of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Child Care Home (FCCH) from, Monday- Saturday from 5:00 AM until 6:00 PM. The Applicant also informed LPA of the intention to provide care for children birth to 14 years of age.

LPA toured the interior and exterior of the home with the Applicant. This home consists of three (3) bedrooms, two (2) bathrooms, formal living room, kitchen/dining area, day-care room, outdoor yard and Accessory Dwelling Unit that is completely off limits to the home and has it's own mailing address.

On limit areas include: day-care room, two (2) bedrooms to be used; for one napping room and one older children/TV room that will also be used for isolation purposes, bathroom, outdoor yard. LPA notes that children will pass through the formal living room to have access to the outdoor yard, per Applicant, children will always be accompanied by an adult while walking through the formal living room.

Off Limit areas include: Applicant's master bedroom and bathroom, kitchen and formal living room.

LPA observed the formal living room has a fireplace that is screened. The home's bathroom to be used for children's care is observed to be clean and free of toxins. All medication in the home will be stored in Applicant's master bedroom that is inaccessible to children in care. LPA observed all cleaning compounds in the home stored in secured cabinets underneath sink in the kitchen and in the an elevated cabinet in the laundry room. LPA observed sharps on an elevated shelf in a kitchen which is beyond the reach of children.
CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/21/2022
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: MURGUIA FAMILY CHILD CARE
FACILITY NUMBER: 426216327
VISIT DATE: 06/21/2022
NARRATIVE
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LPA observed a required fire extinguisher 2A10BC in the home which was serviced on 06/21/22. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has a combination smoke and carbon monoxide detector which were tested at 3:45 PM and found to be operable. Applicant received fire clearance from Santa Maria Fire Department on 6/20/22.

LPA's record review revealed Applicant completed Preventative Health training on 1/27/21. Further, Applicant completed Mandated Reporter training on 2/10/21, and Pediatric CPR/First Aid (EMSA approved) on 11/20/21. LPA reminded Applicant of obligation to maintain current training and certifications. LPA reviewed Applicant's control of property document (Lease Renewal Addendum). Applicant does not have liability insurance for the home as of yet but Applicant is planning on getting insurance. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282).

LPA reviewed with Applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 applicant 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 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

CONT 809-C

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

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
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: MURGUIA FAMILY CHILD CARE
FACILITY NUMBER: 426216327
VISIT DATE: 06/21/2022
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To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the Applicant Piedad Murguia. The home meets Title 22 Division 12 requirements of a large FCCH license. Effective date of license will be noted as the present, 06/21/22.

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

DATE: 06/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2022
LIC809 (FAS) - (06/04)
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