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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216659
Report Date: 08/10/2023
Date Signed: 08/10/2023 01:03:10 PM

Document Has Been Signed on 08/10/2023 01:03 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:BUENROSTRO FAMILY CHILD CAREFACILITY NUMBER:
426216659
ADMINISTRATOR:AMALIA BUENROSTROFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(928) 710-0767
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/10/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
11:31 AM
MET WITH:Amalia BuenrostroTIME COMPLETED:
01:00 PM
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On 8/10/23, Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced Prelicensing Inspection of the abovementioned home and met with Applicant, Amalia Buenrostro. LPA informed Applicant of the nature and purpose of the inspection. LPA notes there are no children on site at the time of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Child Care Home (FCCH) from, Monday- Saturday from 5:30 AM to 5:30PM. The Applicant also Informed LPA of the intention to provide care for children birth to 13 years of age.

LPA toured the interior and exterior of the home with the Applicant. This is a single level home that consists of three (3) bedrooms, two (2) bathrooms, daycare room, living room, dining area, kitchen, laundry room, outdoor yard and detached Accessory Dwelling Unit (ADU) that is currently under construction. Applicant reported that the main area used for childcare services will be the daycare room, one (1) bathroom and outdoor yard. Children will go through the living room, dining area, and kitchen only when going to the outdoor yard. In addition, children will always be accompanied by an adult. Meanwhile three (3) bedrooms, one (1) bathroom, laundry room and detached ADU will be completely inaccessible to children in care. LPA observed all bedrooms and laundry room have door safety knobs.

The FCCH has ample spacing and ventilation for children in care. LPA observed plenty of napping equipment and items for children in care. LPA observed a fireplace in the living room that is made inaccessible by means of a screen. LPA observed a fireplace in the daycare room that is closed off and made inaccessible as it is completed covered up. The restroom to be used for children care is observed to be clean and free of toxins. LPA observed sharps are stored in an elevated cabinet in the kitchen that is inaccessible to children in care. Cleaning compounds were observed in the laundry room in elevated cabinets. Per applicant there is no medication in the home but whenever there is medication it will be stored in an elevated cabinet in the kitchen. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/10/2023
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: BUENROSTRO FAMILY CHILD CARE
FACILITY NUMBER: 426216659
VISIT DATE: 08/10/2023
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LPA observed a required fire extinguisher 2A10BC in the home which was serviced on 5/3/23. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has smoke and carbon monoxide detectors which were tested at 11:50 AM and found to be operable.

LPA observe the outdoor yard to be completely fenced. LPA observed the exits are secured. LPA observed part of the outdoor yard is made inaccessible by means of a fence. There is a ADU in the part of the yard that is inaccessible to children in care. Applicant reports that the ADU is currently undergoing construction and understand that prior to any adult moving into the ADU must be fingerprint cleared prior to moving in. Applicant reported filtered water will be accessible by means of individual water cups. LPA notes no bodies of water were observed. Per Applicant there are no guns or ammo in the home.

LPA record review revealed Applicant completed Preventative Health training on 04/13/23. Further, Applicant completed Mandated Reporter training on 2/1/23, and Pediatric CPR/First Aid (EMSA approved) on 01/22/23. FCCH orientation was completed on 1/31/23. LPA reminded Applicant of obligation to maintain current training and certifications. LPA reviewed Applicant's control of property document (rental agreement). Applicant does not have liability insurance for the license as of yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282). Applicant received fire clearance for a large license from Santa Maria Fire Department on 08/02/23.



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.

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. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
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: BUENROSTRO FAMILY CHILD CARE
FACILITY NUMBER: 426216659
VISIT DATE: 08/10/2023
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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.

Exit interview was conducted with Applicant, Amalia Buenrostro. The home meets Title 22 of CCR requirements for a Large Family Child Care license effective today. Effective date of license is today 08/10/23. Applicant was provided with Notice of Site Visit which must remain posted for the next 30 days.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2023
LIC809 (FAS) - (06/04)
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