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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216555
Report Date: 10/02/2024
Date Signed: 10/02/2024 05:07:08 PM

Document Has Been Signed on 10/02/2024 05:07 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:PINEDA-CORTEZ FCCHFACILITY NUMBER:
426216555
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
10/02/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:50 PM
MET WITH:Amelia Cortez de PinedaTIME VISIT/
INSPECTION COMPLETED:
05:25 PM
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On October 2, 2024, @ 1:50 PM, Licensing Program Analyst (LPA) Martina Jimenez, conducted an unannounced Inspection for the purpose of performing a Case Management- Change of Capacity inspection. LPA met with Amelia Cortez de Pineda, licensee's mother and Raul Pineda Aguilar, licensee's father. LPA explained the nature/purpose of the inspection. Licensee arrived at 2:17 PM, with two (2) children. Licensee own child and C6 is a child in care.

LPA asked the licensee how many children were currently enrolled, licensee stated three (3). LPA informed the licensee there are six (6) children currently in care. The licensee stated C6 is not enrolled in the day-care, I just picked C6 pick up from school, and the mother will be picking C6 up right now. Licensee stated four (4) children are day-care children and two (2) are licensee's own children.

During this inspection, LPA and Ms.Cortez de Pineda, together toured the interior and exterior of the FCCH. LPA observed in the children's play area a shovel accessible to children in care.

At 2:34 PM, LPA observed C5 open the safety gate enter the kitchen, open the refrigerator. Licensee stated "haven't I told you not to go into there." LPA informed the Continues on LIC809C & LIC80D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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: PINEDA-CORTEZ FCCH
FACILITY NUMBER: 426216555
VISIT DATE: 10/02/2024
NARRATIVE
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licensee if an area is accessible to children in care it is open for inspection.

LPA observed in the kitchen Vitamins on the kitchen counter. LPA also observed the cabinet under the sink was unsecured. LPA observed the safety locks to be broken and missing, making the cleaning products accessible to children in care.

LPA observed a regulation 2A10BC fire extinguisher in the FCCH which was serviced on August 30, 2023. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee tested the combination smoke and carbon monoxide detectors tested at 3:58 pm and were functioning at the time of the inspection. Licensee stated that there are no guns or ammunition in the home. Licensee stated she does not hold a foster family license.

No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

The licensee Pediatric First Aid/CPR certificate is valid until March 8, 2025. Licensee Mandated Reporter Training certificate is valid until June 5, 2026. The licensee provided proof of control of property. Control of property was verified via receipt of lease agreement. Because the applicant, rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the licensee confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).


Continues on LIC809C & LIC80D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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: PINEDA-CORTEZ FCCH
FACILITY NUMBER: 426216555
VISIT DATE: 10/02/2024
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Licensee was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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 platforms. 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.

On this date, 10/02/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.


Continues on LIC809C & LIC80D
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: PINEDA-CORTEZ FCCH
FACILITY NUMBER: 426216555
VISIT DATE: 10/02/2024
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LPA discussed the safe sleep regulations with licensee, and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource.

On 04/16/2024, the Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s capacity from 8 (Small FCCH) to 14 (Large FCCH). The Santa Maria Fire Department granted a fire clearance following an inspection completed at FCCH on 07/25/2024.

The FCCH license is pending Manager's Approval. This inspection will continue on a later date, due to the evaluator manual will not open to cited the regulatory violations.

Today’s visit was conducted in Spanish by LPA Jimenez. A notice of site visit was given to applicant 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, Brenda Pineda Cortez.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
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