426217017-7-3-2024-17-CC-SMAZ-D6TSUK-20240703141116

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426217017
Report Date: 07/03/2024
Date Signed: 07/03/2024 02:11:25 PM

Document Has Been Signed on 07/03/2024 02:11 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	RUBALCAVA FCC AKA RAISING LITTLE SEEDS CHILD CARE		FACILITY NUMBER:	426217017
ADMINISTRATOR/ DIRECTOR:	LEONOR PAZ DE RUBALCAVA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 478-2085
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	07/03/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:30 PM
MET WITH:	Leonor Paz De Rubalcava		TIME VISIT/ INSPECTION COMPLETED:	02:26 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 July 3, 2024 at 12:45 PM, Licensing Program Analysts (LPAs) Susana Martinez and Elizabeth George conducted an announced pre-licensing inspection. LPAs met with applicant Leonor Paz De Rubalcava and advised her of the purpose for the inspection. At the time of inspection there were no other adults in the home and no children present. Applicant plans on operating M-F 5 AM- 6PM and Sat 5 AM- 1:30 PM. LPA's toured the interior and exterior of the home with the Applicant. This is a two- story home with four (4) bedrooms and three (3) bathrooms, one (1) formal living room, one (1) regular living room, enclosed patio, one (1) dining room, kitchen, laundry room, garage and outdoor yard. The home's living rooms, kitchen, dining area, downstairs bedroom, downstairs bathroom and outdoor yard will be used for childcare services. Meanwhile, the laundry room, garage and entire second floor are off limits and inaccessible to children in care. LPA's observed living room to have fire place secured. In addition, LPA observed a baby gate located on the first step of the stairway, making the entire second floor inaccessible for children in care. The FCCH has ample spacing and ventilation for children in care. The restroom that will be used for the children was observed to be clean and free of toxins. In the kitchen, LPA's observed sharps are stored in an elevated cabinet in the kitchen that is inaccessible to children in care. Cleaning compounds were observed in an elevated cabinet inside the kitchen as well as secured in the laundry room. LPAs observed a required fire extinguisher 3A10BC in the home which was purchased on 4/21/24. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has dual smoke and carbon monoxide detectors throughout the home. Applicant tested detector in the living room at 12:53 PM and found to be operable. LPA's observe the outdoor yard to be completely fenced. LPA observed cement and grass area for the children. LPA's observed there is plenty of shading for the children play area. Age appropriate toys were observed inside and outside of the home. No bodies of water were observed at the time of inspection. Applicant denies having guns/ammunition in the home. Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUBALCAVA FCC AKA RAISING LITTLE SEEDS CHILD CARE	FACILITY NUMBER: 426217017
	VISIT DATE: 07/03/2024

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
26
27
28
29
30
31
32

Applicant's Pediatric First Aid/CPR certificate is valid through 08/07/2024. Licensee was reminded to renew her certification every two years. Licensee was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. Applicant's mandated reporter certificate is valid through 08/03/2024.

The following was discussed with the applicant:

In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization's, and a valid criminal record clearance associated to the facility license.

A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. Mandated reporter requirements was reviewed and explained.

Smoking is prohibited in a family child care home, 24/7.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs permitted in the facility.
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 license 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.

Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUBALCAVA FCC AKA RAISING LITTLE SEEDS CHILD CARE	FACILITY NUMBER: 426217017
	VISIT DATE: 07/03/2024

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
26
27
28
29
30
31
32

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.

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.

On this date, 07/03/2024, 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.

LPA discussed the safe sleep regulations with licensee 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.

Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUBALCAVA FCC AKA RAISING LITTLE SEEDS CHILD CARE	FACILITY NUMBER: 426217017
	VISIT DATE: 07/03/2024

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
26
27
28
29
30
31
32

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.

The following resources were provided to the applicant:

- Pictorial handout of items not permitted in a licensed facility.

- Entrance Checklist (LIC126).

- Infant Safe Sleep Log.

- Disaster/Fire Drill Log.

- Pictorial handout of Large FCCH (English and Spanish).

A fire clearance was granted by the Santa Maria Fire Department on 06/20/2024.

The home meets Title 22 Division 12 requirements of a Large FCCH. Effective date of license is today, July 03, 2024. Once licensed, the applicant is required to comply with the terms and limitations stated on the license.

A notice of site visit was given 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 Leonor Paz De Rubalcava.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4