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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216403
Report Date: 09/12/2022
Date Signed: 09/13/2022 10:59:59 AM

Document Has Been Signed on 09/13/2022 10:59 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:BARRON FCC AKA BARRON FAMILY DAYCAREFACILITY NUMBER:
426216403
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
09/12/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Francisca BarronTIME COMPLETED:
11:13 AM
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On September 12th, 2022 at 9:00 AM, Licensing Program Analyst (LPA) Rosie Breault conducted an announced inspection for the purpose of performing a pre-licensing inspection. LPA asked Applicant Pre-Screening questions related to COVID-19. Applicant's responses to the Pre-screening questions suggest no COVID-19 exposure on site.

LPA met with applicant Francisca Barron and discussed the purpose of the Inspection. LPA and applicant together toured the interior and exterior of the home. At the time of the inspection there was only applicant present. All adults (2) in the home are fingerprint cleared.

During this tour the following was noted:

Family members residing in the home are two (2) adults and three (3) children under the age of eighteen (18) years old. Per applicant, the operating hours will be Monday through Friday from 7:30am – 6:30pm

All areas identified on the facility sketch were inspected. This is a single home which consists of four (4) bedrooms, two (2) restrooms, two (2) living rooms, one (1) playroom, kitchen, dining room, garage, and outdoor play area. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/13/2022
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: BARRON FCC AKA BARRON FAMILY DAYCARE
FACILITY NUMBER: 426216403
VISIT DATE: 09/12/2022
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Off limit areas included: All four bedrooms, master bathroom, and garage are excluded from childcare services. LPA observed one (1) fireplace in a living room which has been made inaccessible to children.

Applicant stated that children will have access to: both living rooms, playroom, one bathroom, dining room, kitchen and outdoor play area.

There are age appropriate toys and napping equipment on the premises. Knives and medication for the family are stored out of children’s reach, inaccessible to children in an elevated cabinet in the kitchen. The outdoor area is completely fenced with lock secured and no bodies of water present. LPA notes there is ample shade for children.

The required fire extinguisher 2A10BC was purchased on 9/4/2022. Combination Smoke detector and carbon monoxide detector was tested at 9:30AM and was functioning at the time of the visit. Per applicant, stated there are no guns and ammunition in the home. First Aid and emergency kits are available.

The Applicant completed the FCCH Orientation on 4/26/2022. The applicant has current Pediatric First Aid and CPR which expires 2/9/2024. Applicant took the Preventative Health on 1/20/2022. Applicant completed the Mandated Reporter Training on 6/21/2021.

LPA reviewed with applicant the LIC311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

CONTINUED on LIC809C

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

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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: BARRON FCC AKA BARRON FAMILY DAYCARE
FACILITY NUMBER: 426216403
VISIT DATE: 09/12/2022
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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, provided applicant with Safe Sleep Information handout, 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.

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.

CONTINUED ON LIC809C

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

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
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: BARRON FCC AKA BARRON FAMILY DAYCARE
FACILITY NUMBER: 426216403
VISIT DATE: 09/12/2022
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The home meets Title 22 Division 12 requirements of a small FCCH license. Effective date of license will be noted as date of inspection 9/12/2022.

An exit interview was conducted and report reviewed with applicant.

Due to LPA system malfunctioning and non-operable. Copy of report sent to licensee via email: hernandez0985@gmail.com for signature.

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

DATE: 09/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022
LIC809 (FAS) - (06/04)
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