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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216422
Report Date: 02/19/2025
Date Signed: 02/19/2025 04:43:45 PM

Document Has Been Signed on 02/19/2025 04:43 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:VARGAS FAMILY CHILD CAREFACILITY NUMBER:
426216422
ADMINISTRATOR/
DIRECTOR:		GRISELDA VARGAS MADRIGALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 363-0994
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 13DATE:
02/19/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:15 PM
MET WITH:Griselda VargasTIME VISIT/
INSPECTION COMPLETED:
04:50 PM
NARRATIVE
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On 2/19/2025 at 1:15 PM, Licensing Program Analyst (LPAs) Gigi Reyes and Fernando Hernandez conducted an unannounced Annual Inspection at the above Family Childcare Home (FCCH). LPA met with Licensee, Griselda Vargas and discussed the purpose of the inspection. FCCH operates Monday to Friday, 5:30 AM to 5:30 PM, Licensee provides care for children aged 0 months to 13 years old.

Upon arrival, LPA Reyes observed two (2) infants, five (5) napping children over 2 years old, and six (6) chool age children playing in the completely fenced backyard under the sole care of Licensee. Licensee stated that her husband/assistant had left for the grocery store around 12:30 PM and the six school age children had early dismissal from the elementary school and were dropped off to day care on or about 1:10 PM. Approximately five (5) minutes after LPA’s arrival, Licensee’s minor assistant arrived, followed shortly by the assistant/husband.
LPA and Licensee toured the home. LPA observed that required forms are posted in prominent location. Smoke and carbon monoxide detectors were tested and found functional. Fire Extinguisher was purchased on 6/18/2024. Age-appropriate toys, books, playpen, and equipment were observed in the home. Children’s bathroom is free of toxins.
Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/19/2025
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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426216422
VISIT DATE: 02/19/2025
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 Sharps, medicines, and toxins are stored in the area inaccessible to children in care. The backyard is enclosed with a wooden fence and retaining cinder block wall.

LPA reviewed the facility file and confirms that Licensee holds a current Pediatric CPR and First Aid certificate with expiration date of 1/23/2026 while Mandated Reporter Training expires on 7/27/2026. Children’s records were reviewed, Licensee monitors napping infants but did not document it on the safe sleep log.

LPA did not observe bodies of water was observed. Licensee stated that no guns and ammunition are stored separately in a safe in the inaccessible area.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025
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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426216422
VISIT DATE: 02/19/2025
NARRATIVE
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Licensee, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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 additional resource.

LPA also informed licensee, 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.

The FCCH is not providing Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/19/2025 04:43 PM - It Cannot Be Edited


Created By: Gigi Reyes On 02/19/2025 at 03:44 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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426216422

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/19/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102416.5(e)

(e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).


This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, upon arrival, LPA Reyes observed 2 infants, five older children napping and six school age children playing in the completely fenced backyard under the sole care of Licensee which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 02/20/2025
Plan of Correction
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During the inspection, the deficiency was corrected upon the arrival of the minor assistant and licensee's husband/assistant within 5 minutes following LPA's arrival at the FCCH. Licensee shall submit a written POC outlining measures how to ensure that FCCH will maintain the capacity limit. Submit no later thatn 2/20/2025
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:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 02/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/19/2025


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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: VARGAS FAMILY CHILD CARE
FACILITY NUMBER: 426216422
VISIT DATE: 02/19/2025
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During the exit interview, the LICENSEE, Griselda Vargas confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

During today's inspection, Type A deficiency was cited under Title 22 Division 12. and Health and Safety Code.



LPA Reyes informed licensee, Ms. Vargas that this report dated 2/19/2025 documents one (1) Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.
Also, LPA Reyes informed the licensee, Ms. Vargas to provide a copy of this licensing report dated 2/19/205 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.
.

Exit interview conducted and report was reviewed with the licensee, Griselda Vargas.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 02/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/19/2025
LIC809 (FAS) - (06/04)
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