426216917-3-29-2024-17-CC-FVEZ-D3TU8S-20240329152201

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216917
Report Date: 03/29/2024
Date Signed: 03/29/2024 03:22:10 PM

Document Has Been Signed on 03/29/2024 03:22 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:	PORTILLO FAMILY CHILD CARE		FACILITY NUMBER:	426216917
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	03/29/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:22 PM
MET WITH:	Elourde Portillo		TIME COMPLETED:	03:40 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 3/29/24 at 1:20 PM Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced Pre-licensing Inspection and met with Applicant, Elourde Portillo. 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 5:00 PM, Monday- Saturday. The applicant also informed LPA of the intention to provide care for children 0 months to 13 years of age. Applicant was informed changes in licensing hours and/or the ages of children supervised and cared for can be altered upon notifying CCLD in writing of the given modifications and/or changes. The applicant reports there are six (6) adults that live in the home and six (6) 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 four (4) bedrooms and three (3) bathrooms, garage, laundry room, dining area, kitchen, living room, outdoor back yard and outdoor front yard. The applicant reported the daycare services will be provided in the dining area, kitchen, living room, one (1) bathroom and the outdoor front yard. Meanwhile four (4) bedrooms, two (2) bathrooms, garage, laundry room and the outdoor back yard will be inaccessible to children in care. LPA observed all bedroom doors need to have a security doorknob or a small gate needs to be placed in the hallway to make the bedrooms off limits. LPA observed that the dining area, kitchen, living room, one (1) bathroom and outdoor front yard have plenty of spacing and ventilation for the comfort of children in care. LPA observed a fireplace in the living room that needs to be covered and secured. LPA observed sharps are stored on top of the refrigerator. Cleaning compounds are stored in the laundry room or the garage. Medication for the family will be stored in an elevated cabinet in the kitchen. The bathroom that will be used by children was observed to have shampoos and hygiene items within reach of the children. Applicant agrees to ensure these items are inaccessible to children in care. 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: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

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: PORTILLO FAMILY CHILD CARE	FACILITY NUMBER: 426216917
	VISIT DATE: 03/29/2024

NARRATIVE

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LPA observed a required fire extinguisher (2A10BC) in the home that was purchased, but Applicant does not have receipt to proof date of purchase. Applicant agrees to submit proof of receipt or purchase a new fire extinguisher if Applicant is unable to find original receipt. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has a smoke detector that was tested at 1:30 PM and was operable. Additionally, the home has a carbon monoxide detector that was tested at 1:30 PM and was operable.

Applicant reported that the outdoor back yard will be inaccessible to children in care. LPA observed the door that led to the outdoor back yard needs to have an additional safety lock to ensure children will not have access to the outdoor back yard. In the outdoor back yard, LPA observed the yard is completely fenced. There are two sheds in the outdoor back yard. Applicant understands that children can not use this yard, as Applicant has identified that it is inaccessible.

LPA observed the outdoor front yard is fenced, but the fence does not close completely. LPA requested to ensure the fence can be securely locked. LPA observed there is plenty of shading for the comfort of children. LPA and applicant discussed adding shade during the hot summer months. LPA and applicant discussed active supervision when children are in the outdoor patio. Applicant reported filtered water will be accessible by means of a water jug and individual water cups. LPA notes no bodies of water were observed. Applicant reported there are no guns and ammo in the home.

LPA's record review revealed Preventative Health training was complete on 2/24/24. Further, Applicant completed Mandated Reporter training on 1/30/24 and Pediatric CPR/First Aid (EMSA approved) on 1/27/24. Applicant completed FCCH orientation on 2/13/24. 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: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

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: PORTILLO FAMILY CHILD CARE	FACILITY NUMBER: 426216917
	VISIT DATE: 03/29/2024

NARRATIVE

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Applicant owns the home. This is a rent to own property that is currently owned by Applicant, spouse, and additional owner of the home. The applicant has not obtained a signed Property Owner/Landlord Consent form (LIC9149). 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.

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.

On this date, 3/29/24 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.

CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

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: PORTILLO FAMILY CHILD CARE	FACILITY NUMBER: 426216917
	VISIT DATE: 03/29/2024

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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, Elourde Portillo in Spanish.

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 meet Title 22 of CCR requirements for a Small Family Child Care license. The following is pending to be able to issue the license.

1.) All bedrooms must have a barrier to ensure they are off limits (door safety knobs or small gate).
2.) Fireplace in the living room must be covered, secured, and inaccessible to children in care.
3.) Applicant will ensure the children’s bathroom does not have any hazardous item within reach of the children.
4.) Proof of fire extinguisher receipt to determine it is within one year of purchase.
5.) Ensure all doors that led to the outdoor back yard are secured and have additional lock.
6.) Submit proof that the fence in the outdoor front yard is secured.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2024

LIC809 (FAS) - (06/04)

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