426216464-11-30-2022-17-CC-GRES-CLNQWD-20221130113144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216464
Report Date: 11/30/2022
Date Signed: 11/30/2022 11:31:52 AM

Document Has Been Signed on 11/30/2022 11:31 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:	EQUIHUA FAMILY CHILD CARE		FACILITY NUMBER:	426216464
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	11/30/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria Isabel Equihua		TIME COMPLETED:	11:30 AM

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 November 30, 2022 at 9:00 AM, Licensing Program Analyst (LPA) Gigi Reyes conducted an announced a pre-licensing inspection and met with Applicant, Maria Isabel Equihua, applicant's spouse, Juan Cardenas and Maria Castillo who interpreted the inspection in Spanish. LPA asked pre-screening questions related to COVID-19, applicant's responses indicate there are no COVID-19 exposure on site. LPA discussed the purpose of the inspection. LPA accompanied by applicant toured the home inside and outside The home is a single story composed of 4 bedrooms, 2 baths, living room, day care room, kitchen, backyard and garage. Applicant stated the living room, day care room, dining area, 1 restroom and backyard will be accessible to children. Off limit areas are 4 bedrooms with child safety lock in each door, kitchen which is enclosed with baby gate and garage which remains locked during day care hours. All cabinets in the kitchen have a safety lock in each door. The 2A10 BC fire extinguisher was purchased on 8/1/2022, applicant was reminded that fire extinguisher should be serviced or to purchase a new one every year. LPA observed age appropriate toys and equipment inside and outside the home. First Aid kit, medicines, toxins and hazardous items are stored inaccessible to children in care. There is a dual carbon monoxide and a smoke detector which was tested and found to be functional. LPA observed a trampoline, applicant stated this will not be used and will remain locked. The backyard is enclosed with a 7 foot wooden fence. Nobodies of water was observed. Applicant stated there are no guns or ammunition in the home. Ms. Equihua completed the Family Child Care Home orientation on 5/5/2022. Preventative Health and Safety Training was completed on 6/9/2022. Pediatric 1st Aid/CPR certificate expires on 4/9/2024 and should be renewed every two years.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

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: EQUIHUA FAMILY CHILD CARE	FACILITY NUMBER: 426216464
	VISIT DATE: 11/30/2022

NARRATIVE

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LPA discussed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, Measles, including verification of TB. Applicant's immunization record is on file

Ms. Equihua completed the Child Abuse Mandated Reporter Training on 8/18/2022 and was reminded that it should be renewed every two years. LPA discussed COVID-19 Mitigation Plan/ and have applicant completed the COVID-19 Self- Assessment Guide
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

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. Children's record keeping requirements were reviewed.

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.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

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: EQUIHUA FAMILY CHILD CARE	FACILITY NUMBER: 426216464
	VISIT DATE: 11/30/2022

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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.

The home/applicant meets the requirements for a Small Family Child Care Home under California Code of Regulation Title 22 Division 12. License was granted effective today, 11/30/2022.

Exit interview conducted and report was reviewed with the applicant, Ms. Maria Isabel Equihua

The report was interpreted in Spanish by Maria Castillo.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022

LIC809 (FAS) - (06/04)

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