426216679-8-28-2023-17-CC-EBAY-CV5W2F-20230828165415

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216679
Report Date: 08/28/2023
Date Signed: 08/28/2023 04:54:27 PM

Document Has Been Signed on 08/28/2023 04:54 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:	GONZALES FCC AKA LOVEOSAURUS FAMILY CHILD CARE		FACILITY NUMBER:	426216679
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 2	DATE:	08/28/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	02:40 PM
MET WITH:	Jessica Gonzales		TIME COMPLETED:	05:15 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 8/28/23, at 2:40 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an announced Prelicense Inspection of the abovementioned home and met with Applicant Jessica Gonzales. 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 8:00 AM- 5:00 PM, Monday- Friday. Applicant also intends to care for children 0 years of age to 12 years of age. Applicant was informed changes in licensing hours or the ages of children supervised and cared for can be altered upon notifying CCLD of the modification or change. LPA notes, two children are in care at the time of the inspection. LPA, in the company of Applicant, toured the interior and exterior of the home in its entirety. The home is a 2 bedroom and one and half bathroom two story townhouse. The home's living room, dining room, bathroom and back patio will be used for child care services, while the remainder of the home is excluded. LPA observed child safety gatse at the entrance of the kitchen and the base of the stairwell. LPA observed a fire extinguisher (2A10BC) in the home which was purchased on 8/28/23. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has combination smoke/ carbon monoxide detectors. A combination smoke/carbon monoxide detector was tested in the living room area at 3:04 PM and found to be operable. LPA observed the home to be clean and orderly. The home has spacing and ventilation for children in care. The home no fireplace. The home has central heating with vents on the ceiling. The bathroom to be used by children in care is observed to be clean and free of toxins. Medication and sharps are observed on elevated shelves in kitchen cabinets which are inaccessible to children in care. Cleaning compounds are stored on the second floor which is excluded from child care. The back patio is enclosed by wooden fencing and the footing is concrete. The Applicant is (CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
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: GONZALES FCC AKA LOVEOSAURUS FAMILY CHILD CARE	FACILITY NUMBER: 426216679
	VISIT DATE: 08/28/2023

NARRATIVE

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reminded to provide direct supervision of children when children are involved in outdoor activities away from the FCCH. LPA observed no bodies of water on site.

LPA's record review revealed Applicant's Mandated Reporter training was completed on 2/13/23 (expiration 2/13/25), and Pediatric CPR/First Aid (EMSA approved) was completed on 10/23/23 (expiration 10/23/25). Applicant completed Preventative Health Training on 6/1/23. LPA reminded Applicant of obligation to maintain current training and certifications. The Applicant has not obtained a signed Property Owner/Landlord Consent form (LIC 9149). Without this consent, the Applicant understands that, once licensed, they can operate with a maximum capacity of 6 children. If property owner/landlord consent is obtained in the future, the applicant is advised that a new Application for a Family Child Care Home License (LIC 279) must be submitted with a change of capacity fee of $25, to increase the capacity and provide care to 8 children. Applicant does not have liability insurance for the home as of yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282). Applicant informed LPA no ammunition or firearms are on site.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

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-andresources/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 of infant devices or their purchased equipment.
(CONT. 809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
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: GONZALES FCC AKA LOVEOSAURUS FAMILY CHILD CARE	FACILITY NUMBER: 426216679
	VISIT DATE: 08/28/2023

NARRATIVE

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On this date, 8/28/23, 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.

Applicant is informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care 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 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 Jessica Gonzales. The home meets Title 22 Division 12 requirements of a FCCH Small License. Effective date of license will be noted as the present, 8/28/23.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
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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