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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216735
Report Date: 11/15/2023
Date Signed: 11/15/2023 12:12:04 PM

Document Has Been Signed on 11/15/2023 12:12 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:FELIX FAMILY CHILD CAREFACILITY NUMBER:
426216735
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
11/15/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:44 AM
MET WITH:Karina Felix-LopezTIME COMPLETED:
12:20 PM
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On 11/15/23, Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced Pre-licensing Inspection and met with Applicant, Karina Felix. LPA informed Applicant of the nature and purpose of the inspection. The applicant informed LPA of the intention to maintain operating hours of a Family Child Care Home (FCCH) from 5:30 AM to 5:30 PM, Monday- Friday and 5:30 AM to 12:30 PM on Saturday. The applicant also informed LPA of the intention to provide care for children 0 months to 12 years of age. The applicant reports two (2) adults live in the home and two (2) 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, dining area, kitchen, garage, and outdoor yard. The applicant reported day care services will occur in the living room, dining area, one (1) bathroom, and part of the outdoor yard will be accessible to children in care. Meanwhile three (3) bedrooms, one (1) bathroom, kitchen, garage, and part of the outdoor yard will be inaccessible to children in care. LPA observed a secured gate making the kitchen inaccessible. LPA observed all bedroom doors and garage door are locked and secured. LPA observed that part of the outdoor yard is made inaccessible by fencing.

LPA observed living room, dining area, one (1) bathroom, and part of the outdoor yard have plenty of spacing and ventilation for the comfort of children in care. LPA observed a fireplace in the living room that is secured by a safety latch. LPA observed sharps are stored in the kitchen pantry. Medication for the family is stored in the kitchen pantry as well. Cleaning compounds were observed to be stored in the garage and under the kitchen sink. LPA notes all these areas are inaccessible to children in care. The bathroom of the FCCH is observed to be clean and free of toxins. LPA observed items, equipment, toys and furnishings for the children in care that are in good condition and age appropriate.

CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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: FELIX FAMILY CHILD CARE
FACILITY NUMBER: 426216735
VISIT DATE: 11/15/2023
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LPA observed a required fire extinguisher (2A10BC) in the home which was purchased on 11/15/23. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has a combination smoke and carbon monoxide detector which was tested at 9:30 AM and found to be operable.

LPA and applicant toured the outdoor yard. LPA observe the outdoor yard is completely fenced and the exits are secured. LPA observed that part of the outdoor yard is inaccessible by means of fencing. LPA observed a small shed that is inaccessible to children in care. In the side of the outdoor yard that is accessible to children, LPA observed shading for the children in care. Applicant and LPA discussed active supervision when children are playing in the outdoor yard. Applicant reported filtered water will be accessible by means of individual water cups. Per Applicant there are no guns or ammo in the home.

LPA observed a body of water- jacuzzi in the outdoor yard of the home. LPA observed the jacuzzi is in the part of the yard that is not accessible to the children in care. LPA observed there is a fence separating the accessible yard and inaccessible yard. LPA observed the jacuzzi has four locks that are secured. There are two ways to have access to the jacuzzi, from the applicant’s master bedroom and going over the fence in the outdoor yard. LPA notes applicant’s master bedroom is inaccessible to children in care. LPA observed the fencing that separates the yards to be locked and secured.

LPA's record review revealed Applicant completed Preventative Health training on 6/1/23. Further, Applicant completed Mandated Reporter training on 3/14/23 and Pediatric CPR/First Aid (EMSA approved) on 1/13/23. Applicant completed FCCH orientation on 3/6/23. LPA reminded Applicant of obligation to maintain current training and certifications. Applicant does not have liability insurance for the license as of yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282).


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.

CONT 809-C

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

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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: FELIX FAMILY CHILD CARE
FACILITY NUMBER: 426216735
VISIT DATE: 11/15/2023
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The applicant rents the home and provided proof of control of property. 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 applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

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 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.



Applicant, informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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, Karina Felix.

CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
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: FELIX FAMILY CHILD CARE
FACILITY NUMBER: 426216735
VISIT DATE: 11/15/2023
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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 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, 11/15/23, 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 addresses. Under state law, some registered sex offenders are not subject to public; 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.

The home meets Title 22 of CCR requirements for a Small Family Child Care license effective today. Effective date of license is today 11/15/23.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023
LIC809 (FAS) - (06/04)
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