426216666-8-28-2023-17-CC-FVEZ-CV62SB-20230828173852

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216666
Report Date: 08/28/2023
Date Signed: 08/28/2023 05:39:02 PM

Document Has Been Signed on 08/28/2023 05:39 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:	ESPINOZA DUARTE FAMILY CHILD CARE		FACILITY NUMBER:	426216666
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	08/28/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	04:04 PM
MET WITH:	Maria Espinoza Duarte		TIME COMPLETED:	05:45 PM

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 08/28/23, Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced Pre-licensing Inspection and met with Applicant, Maria Espinoza Duarte. LPA informed Applicant of the nature and purpose of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Child Care Home (FCCH) from 05:00 AM to 5:30 PM, Monday- Saturday. Applicant also informed LPA of the intention to provide care for children 0 months to 12 years of age. Per applicant, there are two (2) adults living in the home and both adults have received criminal record clearance. LPA toured the interior and exterior of the residence with the Applicant. This is a single-story home that consists of three (3) bedrooms, two (2) bathrooms, living room, kitchen, dining room, garage and outdoor playground. Applicant reported most day care services will occur in the living room, dining room, kitchen, bathroom, and outdoor playground. Meanwhile, three (3) bedrooms, one (1) bathroom, and garage will be made inaccessible to children in care. LPA observed bedrooms and garage have door safety knob ensuring inaccessibility to children in care. LPA observed the living room, dining room and kitchen to have spacing and ventilation for the comfort of children in care. LPA observe a fireplace in the home that is made inaccessible to children in care by means of a gate. LPA observed two open face heaters that will be made inaccessible by magnetic covers. LPA observed sharps are stored in an elevated cabinet in the kitchen. Medication for the family is stored in the applicant’s bedroom that is inaccessible to children in care. Cleaning compounds were observed to be stored in the garage that is also inaccessible to children in care. The bathroom of the FCCH is observed to be clean and free of toxins. LPA observed all items, equipment, toys and furnishings are in good conditions and age appropriate. LPA observed a required fire extinguisher (2A10BC) in the home which was purchased on 08/19/22. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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: ESPINOZA DUARTE FAMILY CHILD CARE	FACILITY NUMBER: 426216666
	VISIT DATE: 08/28/2023

NARRATIVE

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The home has a combination smoke and carbon monoxide detector which were tested at 4:30PM and found to be operable.

LPA and applicant toured the outdoor playground. LPA observed the outdoor playground to be completely fenced. LPA observed all exits are secured. There is plenty of shade to afford the children in care. LPA and applicant discussed active supervision when children are outdoors. Applicant will provide filtered water for children by means of individual water cups. LPA did not observe any bodies of water. Applicant reported no guns or ammunition are stored in the FCCH.

LPA's record review revealed Applicant completed Preventative Health training on 11/17/22. Further, Applicant completed Mandated Reporter training on 01/02/23 and Pediatric CPR/First Aid (EMSA approved) on 10/26/22. Applicant completed FCCH orientation on 11/15/22. LPA reminded Applicant of obligation to maintain current training and certifications. LPA reviewed Applicant's control of property document (rental agreement). LPA notes applicant is current with all required immunizations. Applicant does not have liability insurance for the home as of yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282). LPA notes landlord signed LIC9149 allowing applicant to care for up to 8 children at once.

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: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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: ESPINOZA DUARTE FAMILY CHILD CARE	FACILITY NUMBER: 426216666
	VISIT DATE: 08/28/2023

NARRATIVE

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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 conducted and report was reviewed with the Applicant, Maria Espinoza Duarte. The home meets Title 22 Division 12 requirements of a small FCCH license. Effective date of license will be noted as today, 08/28/23. This report was reviewed by LPA Velazquez in Spanish due to Spanish being the primary language of the applicant.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

LIC809 (FAS) - (06/04)

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