426216786-12-5-2023-17-CC-FVEZ-CY94LE-20231205181149

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216786
Report Date: 12/01/2023
Date Signed: 12/05/2023 06:12:27 PM

Document Has Been Signed on 12/05/2023 06:12 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:	RUIZ FAMILY CHILD CARE		FACILITY NUMBER:	426216786
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	12/01/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Josefina Ruiz		TIME COMPLETED:	12:35 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 12/01/23, Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced Pre-licensing Inspection and met with Applicant, Josefina Ruiz. 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 5:00 AM to 6:00 PM, Monday- Saturday. The applicant also informed LPA of the intention to provide care for children 0 months to 12 years of age. The applicant reports there are four (4) adults that live in the home and four (4) adults have receive criminal record clearance. LPA toured the interior and exterior of the residence with the Applicant. This is a single-story home with an attached studio. The main home consists of three (3) bedrooms, two (2) bathrooms, living room, dining area, kitchen, garage, and outdoor yard. The attached studio consists of two (2) bedrooms, one (1) bathroom and full kitchen. Applicant reported day care services will occur in the living room, dining area, kitchen, and one (1) bathroom. Meanwhile three (3) bedrooms, one (1) bathroom, garage, attached studio and outdoor yard will be inaccessible to children in care. Applicant reports the outdoor yard will be made inaccessible for now until Applicant is able to make changes to the outdoor yard. Applicant reported that she will be adding a gate to make all three (3) bedrooms inaccessible to children. LPA observed the residence has access to the attached studio through a door in the living room of the main residence. LPA observed this door to be locked and secured. LPA observed that the living room, dining room, kitchen and one (1) bathroom have plenty of spacing and ventilation for the comfort of children in care. LPA observed a fireplace that is accessible to children. Applicant reported she will be making the fireplace inaccessible with a white board. LPA observed sharps are stored in a kitchen drawer that does not have a lock. Applicant reported she will be placing locks in all the kitchen cabinets. Medication for the family is stored in an elevated cabinet in the kitchen. Cleaning compounds were observed to be stored under the kitchen sink that is not locked and in the garage. The bathroom of the FCCH is observed to be clean and free of toxins. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426216786
	VISIT DATE: 12/01/2023

NARRATIVE

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LPA did not observe items, equipment, toys and furnishings for the children in care. Applicant reported she will be purchasing items and will provide LPA with pictures of the items.

LPA observed a required fire extinguisher (2A10BC) in the home which was purchased on 11/30/23. 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 that was tested at 10:30 AM and was operable.

LPA and applicant toured the outdoor yard. LPA observed the outdoor yard to be completely fenced and the exit gates are secured. Applicant reported that the outdoor yard will be temporarily inaccessible. Applicant will be adding fences to make part of the outdoor yard inaccessible to children in care. Applicant understands the outdoor yard will need to be inspected for safety prior to the children using the outdoor yard. 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's record review revealed Applicant completed Preventative Health training on 11/1/23. Further, Applicant completed Mandated Reporter training on 8/17/23 and Pediatric CPR/First Aid (EMSA approved) on 8/19/23. Applicant completed FCCH orientation on 7/26/23. 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.

The applicant owns the home. The applicant provided proof of control of property.

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. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426216786
	VISIT DATE: 12/01/2023

NARRATIVE

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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.

On this date, 12/1/23, 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.

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, Josefina Ruiz in Spanish.
CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426216786
	VISIT DATE: 12/01/2023

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 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.

The home does not meets Title 22 of CCR requirements for a Small Family Child Care license. Prove of the following must be submitted by the Applicant prior to issuing a Small Family Child Care license.

1.) Fireplace must be inaccessible to children in care.
2.) Safety gate must be secured to make the bedrooms inaccessible.
3.) Sharps and toxins must be inaccessible to children in care.
4.) Crib or play pen for napping and some items for children to play with during day care hours.

Once the Applicant, Josefina Ruiz submits prove of the corrections a Small Family Child Care license will be issued.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

LIC809 (FAS) - (06/04)

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