426216717-11-27-2023-17-CC-MJIZ-CXYSDR-20231127124733

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216717
Report Date: 11/27/2023
Date Signed: 11/27/2023 12:47:41 PM

Document Has Been Signed on 11/27/2023 12:47 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:	GARCIA FAMILY CHILD CARE		FACILITY NUMBER:	426216717
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 5	CENSUS: 2	DATE:	11/27/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Jennifer Garcia		TIME COMPLETED:	12:55 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 11/27/2023, Licensing Program Analyst (LPA) Martina Jimenez, conducted an announced Pre-licensing inspection for a Small Family Child Care Home (FCCH) license. LPA met with Jennifer Garcia, applicant, the purpose of the inspection was discussed. LPA and Applicant together toured the inside and outside of the home. There were two (2) children present at the time of the inspection. Per Applicant, the operating hours will be Monday through Friday from 5:30 a,m. to 5:30 p.m. Applicant states she wants to care for children from birth to 13 years of age. The home is a single level home that consists of five (5) bedrooms, two (2) bathrooms, living room, kitchen, dining area, family room, laundry room, garage and outdoor play area. The areas used for the day-care are the living room, dining room, one (1) bedroom#4, one (1) bathroom, and outdoor play area. The four(4) bedrooms, one (1) bathroom, living room, and garage will be inaccessible to children in care. LPA observed the four bedrooms, living room, kitchen and garage have safety locks, safety door knobs covers, and safety gate, making these areas inaccessible to children in care. LPA observed the FCCH is fully equipped to meet the needs of children in care. LPA observed that the FCCH is clean and orderly. In addition, there is plenty of ventilation for the children in care. LPA observed a fireplace in the family room that is covered and secured. LPA observed that knives and medication are stored in an elevated cabinet in the hallway pantry and master bathroom. Cleaning compounds were observed in the laundry room with a safety door knob cover making these items inaccessible to children. The bathroom to be used for children in care was observed to be clean and free of toxins. LPA observed child size furniture and material for activities throughout the home in areas that will be accessible to children in care. Continue LIC 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 426216717
	VISIT DATE: 11/27/2023

NARRATIVE

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LPA and applicant toured the outdoor yard. LPA observed the exits to be secured. LPA observed there is shade for the children in care. Filtered water will be accessible by means of water jug with individual water cups. The back yard has age-appropriate toys and day-care equipment. LPA and applicant discussed active supervision when children are in the outdoor yard.

LPA observed a regulation 2A10BC fire extinguisher in the FCCH at the time of the inspection. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA observed applicant test a combination smoke and carbon monoxide detectors in the home at 10:24 AM and were functioning at the time of the inspection.

Applicant stated that there are no weapons or ammunition in the home. Applicant stated she does hold a foster family license. Applicant is current with immunization required per SB 792. Applicant Pediatric First Aid/CPR certificate is valid until 07/05/2025. Applicant completed the Preventative Health on 06/11/2023. Applicant’s Mandated Reporter Training certificate is valid until 03/30/2025. The Applicant completed the Orientation on March 9, 2023.

There are six (6) adults living in the home, all adults have been fingerprint cleared. 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

The applicant, provided proof of control of property. Control of property was verified via receipt of rental lease. Because the applicant, rents/leases the home, proof of landlord notification is required.
Continues in LIC 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 426216717
	VISIT DATE: 11/27/2023

NARRATIVE

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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 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. Entrance Checklist was provided to the applicant.
LPA reviewed with applicant, the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

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. Entrance Checklist was provided to the applicant.

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. Continues on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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: GARCIA FAMILY CHILD CARE	FACILITY NUMBER: 426216717
	VISIT DATE: 11/27/2023

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The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

On this date, 08/04/2023, 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 addresses. 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, was 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

The home will be Licensed once Applicant submits verification, via email of the following:

1. Secure kitchen and children's bathroom drawers with sharps and toxins
2. Fire Extinguisher receipt/purchase
3. Secure the gate in the backyard play area leading to front driveway
4. Trampoline
5. Bulletin Board

Verification of the above corrections are to be submitted via email to: Martina.Jimenez@dss.ca.gov by December 4, 2023. License is pending the above corrections. 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 applicant, Jennifer Garcia.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC809 (FAS) - (06/04)

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