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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216526
Report Date: 02/14/2023
Date Signed: 02/14/2023 11:08:38 AM

Document Has Been Signed on 02/14/2023 11:08 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:RODRIGUEZ POSADAS FCCFACILITY NUMBER:
426216526
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
02/14/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Noemi Rodriguez PosadaTIME COMPLETED:
11:10 AM
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On February 14, 2023 at 8:35 AM. Licensing Program Analyst (LPA) Gigi Reyes conducted an announced pre-licensing inspection and met with Applicant, Noemi Rodriguez, adult residents, Omar Barragan and Vanessa Tenorio Rodriguez. 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 in the company of the applicant and Mr. Barragan toured the interior and exterior of the home. This is a one story home composed of 3 bedrooms, 2 baths, living room , kitchen, garage and backyard. Areas accessible to children will be the living room, dining, one bathroom, and backyard. Off limit areas are 3 bedrooms, one bathroom, kitchen, and garage. Off limit areas such as bedrooms/hallway kitchen are enclosed with baby gates making them inaccessible to day care children, LPA observed age appropriate toys, equipment and cots. The 2A10 BC fire extinguisher was purchased on 10/12/2022. There are carbon monoxide and smoke detectors which were tested and found to be functional. Applicant stated there are no guns and ammunition in the home, nobodies of water was observed. The back yard is enclosed with a wooden fence. LPA observed a trampoline. LPA provided and explained the "Trampoline Conditions" to the applicant.

Ms. Noemi Rodriguez completed the Family Child Care orientation on 10/4/2022. Preventative Health and Safety Training was completed on 10/21/2022. Pediatric 1st Aid/CPR certificate expires on 12/17/2024. Mandated Reporter Training expires on 10/27/2024. Applicant stated she does not have liability insurance at this time. LPA discussed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, Measles, including verification of TB. Applicant's verification is on file.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2023
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: RODRIGUEZ POSADAS FCC
FACILITY NUMBER: 426216526
VISIT DATE: 02/14/2023
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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, 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. 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.

Small Family Child Care Home License was granted effective today, February 14, 2023.



Notice of Site Visit was issued. Appeal Rights were given and explained.

Inspection and Report was translated in Spanish by Mr. Omar BarragannExit interview conducted and report was reviewed with the applicant, Ms. Noemi Rodriguez.

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

DATE: 02/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023
LIC809 (FAS) - (06/04)
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