426217077-9-25-2024-17-CC-EBAY-D9FPVG-20240925113907

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426217077
Report Date: 09/25/2024
Date Signed: 09/25/2024 11:39:14 AM

Document Has Been Signed on 09/25/2024 11:39 AM - 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:	CARDONA RUIZ FAMILY CHILD CARE		FACILITY NUMBER:	426217077
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	09/25/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Jannet Cardona Ruiz		TIME VISIT/ INSPECTION COMPLETED:	11:45 AM

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 9/25/24, at 9:00 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an announced Prelicense Inspection of the abovementioned home and met with Applicant Jannet Cardona Ruiz. LPA informed Applicant of the nature and purpose of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Child Care Home (FCCH) from 6:30 AM- 5:00 PM, Monday- Friday. Applicant also intends to care for children 0 years of age to 12 years of age. Applicant was informed changes in licensing hours or the ages of children supervised and cared for can be altered upon notifying CCLD of the modification or change. LPA notes no children are in care at the time of the inspection. LPA, in the company of Applicant, toured the interior and exterior of the home, in its entirety. The home is a three bedroom, two bathroom single story dwelling. The home's living room, dining room, guest room, hallway bathroom and backyard will be used for child care services, while the remainder of the home is excluded form care. LPA observed child safety gates at the entrance of the kitchen and at the intersection of the hallway, just beyond the guestroom and hallway bathroom. LPA observed the home to be clean and orderly. The home has spacing and ventilation for children in care. The home has no fireplace, however the home does have a centralized heating system with vents in various areas on the ceiling. The bathroom to be used by children in care is observed to be clean and free of toxins. Cleaning compounds are observed in a garage cabinet, which is excluded from care. Medication and sharps within the home are located on a elevated shelves in kitchen cabinets. LPA observed a fire extinguisher (2A10BC) in the home which was purchased on 8/30/24. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has combination smoke/carbon monoxide detectors throughout. A combination smoke/carbon monoxide detector in the hallway was tested at 10:40 AM and found to be operable. The home does operable telephone services. Outdoor activities for children will occur in the home's backyard. The backyard is enclosed by wooden fencing and the footing in the area is varied. The backyard is partitioned to separate an area used for personal use from an area used for child care services. The area for child care has (CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

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: CARDONA RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426217077
	VISIT DATE: 09/25/2024

NARRATIVE

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recalls on their purchased equipment. play structures for children of various age groups. Applicant was reminded to ensure children are utilizing play structures which are age appropriate. Additionally, Applicant is reminded to replace outdoor toys, play structures and equipment which is degraded and not in good repair. The area of the backyard partitioned for personal use contains a locked shed and serves as a dog run. The shed in the area contains household items. LPA observed no bodies of water on site.

LPA's record review revealed Applicant's Mandated Reporter training was completed on 4/12/24 (expiration 4/12/26), and Pediatric CPR/First Aid (EMSA approved) was completed on 5/31/24 (expiration 5/31/26). Applicant completed Preventative Health Training on 5/19/24, and completed CCLD's Family Child Care orientation on 4/10/24. LPA reminded Applicant of obligation to maintain current training and certifications. The Applicant provided proof of control of property. Applicant does not have liability insurance for the home as of yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282). The home contains firearms and ammunition. LPA reviewed storage of the aforementioned and notes the items are secured, stored separately and in an excluded area of the home. LPA also observed two dogs on site. LPA notes the vaccination records for the dogs are current.

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.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes 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 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. (CONT. 809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

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: CARDONA RUIZ FAMILY CHILD CARE	FACILITY NUMBER: 426217077
	VISIT DATE: 09/25/2024

NARRATIVE

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On this date, 9/25/24, 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 address. 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 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.

Applicant is 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.

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 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.

Exit interview conducted and report was reviewed with the Applicant Jannet Cardona Ruiz. The home meets Title 22 Division 12 requirements of a FCCH Small License. Effective date of license will be noted as the present, 9/25/24.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

LIC809 (FAS) - (06/04)

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