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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217095
Report Date: 08/01/2024
Date Signed: 08/01/2024 03:33:26 PM

Document Has Been Signed on 08/01/2024 03:33 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:MENDOZA FCC AKA CRIS" DAYCAREFACILITY NUMBER:
426217095
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/01/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Guadalupe MendozaTIME VISIT/
INSPECTION COMPLETED:
03:50 PM
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This is a change of location, previous facility number 406216313.


On 08/01/2024, Licensing Program Analysts (LPAs) Martina Jimenez and Matthew Sapien conducted an announced, Pre-licensing inspection for a Small Family Child Care Home (FCCH) license. LPAs met with Guadalupe Mendoza, applicant, the purpose of the inspection was discussed and together LPA and Applicant toured the inside and outside of the home. There were no children present at the time of the inspection.

The applicant is requesting a small family childcare license. The home is a two (2) story home, which consists of four (4) bedrooms, three (3) bathrooms, loft, living room, kitchen, dining area, garage, completely fenced patio, separate outdoor play area, separate completely fenced pool and Jacuzzi with a gate that opens outward with a self latching gate. LPA notes that the day care services will occur in the living room, dining area, bathroom, completely fenced outdoor play area and separate outdoor play area.

The off-limits areas consist of four (4) bedrooms, two (2)bathrooms, loft, garage, separate completely fenced pool and Jacuzzi with a gate that opens outward with a self latching

This Report Continues on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/01/2024
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 6
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: MENDOZA FCC AKA CRIS" DAYCARE
FACILITY NUMBER: 426217095
VISIT DATE: 08/01/2024
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gate. LPAs observed a safety doorknob covers on the bedroom and garage doors, along with a safety gate at the bottom of the stairs making the four (4) bedrooms, loft, and garage inaccessible to day-care children. LPAs observed the kitchen to have safety locks on drawers and cabinets making these areas inaccessible to children in care.

Per Applicant, the operating hours will be Monday through Friday from 8:00 a.m. to 5:00 p.m. Applicant states she wants to care for children from 0 to 13 years of age.

LPAs observed the FCCH is fully equipped to meet the needs of children in care. LPAs observed that the FCCH is clean and orderly. In addition, there is plenty of ventilation for the children in care. LPA did not observe any toxins nor hazards items accessible to children in care.

LPAs observed that knives were stored in an elevated shelf in the kitchen pantry inaccessible at the time of the inspection. Per applicant there are no medication or vitamins kept in the home.

Cleaning compounds were observed in a secured cabinet under the kitchen sink that was secured at the time of the inspection making the cleaning compounds inaccessible to children in care. The bathroom to be used for children in care was observed to be clean and free of toxins. LPAs observed child size furniture and material for activities throughout the home in areas that will be accessible to children in care.

This Report Continues on LIC809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: MENDOZA FCC AKA CRIS" DAYCARE
FACILITY NUMBER: 426217095
VISIT DATE: 08/01/2024
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LPAs and applicant together toured the outdoor play area. LPAs on the property in a separate area a completely fenced pool and Jacuzzi with a gate that opens outward with a self latching gate. LPAs advised the applicant children must never be unsupervised while the children are at the play area.

LPAs observed the exits to be secured. LPA observed there is shading to afford the children in care. In addition, water will be accessible by means of water bottles with individual water cups. The play area has age-appropriate toys and day-care equipment. LPAs and applicant discussed active supervision when children are in the outdoor yard.

· No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

· All adults living and working in the home shall be made of aware of the Department inspection rights authority.



LPAs observed a regulation 2A10BC fire extinguisher that was purchased on 07/29/2024. Licensee is reminded to service or purchase the fire extinguisher yearly. LPAs observed applicant test a combination smoke and carbon monoxide detectors in the home at 1;56 PM and were functioning at the time of the inspection. Applicant stated that there are no weapons or ammunition in the home. Applicant stated she does hold a foster family license. First Aid and emergency kits are available.

This Report Continues on LIC809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: MENDOZA FCC AKA CRIS" DAYCARE
FACILITY NUMBER: 426217095
VISIT DATE: 08/01/2024
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Applicant is current with immunization required per SB 792. Applicant Pediatric First Aid/CPR certificate is valid until 02/27/25. Applicant’s Mandated Reporter Training certificate is valid until 08/24/2025. Applicant completed the Preventative Health & Safety on 06/09/21. Applicant completed the Orientation on 06/12/2020.

The applicant could not provided proof of control of property at the time of the inspection. Because the applicant, rents/leases the home, proof of landlord notification is required. LPAs 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).

There are two (2) adults living in the home, which all adults residing in the home have been fingerprint cleared. 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.

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 This Report Continues on LIC809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MENDOZA FCC AKA CRIS" DAYCARE
FACILITY NUMBER: 426217095
VISIT DATE: 08/01/2024
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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.

LPAs 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.

LPAs discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep web page at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource.

LPAs 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, 08/01/2024, 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 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. This Report Continues on LIC809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: MENDOZA FCC AKA CRIS" DAYCARE
FACILITY NUMBER: 426217095
VISIT DATE: 08/01/2024
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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.

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.

Applicant was made aware the responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov

The FCCH license is pending verification of the following:



1. Control of property (Rental lease/agreement)

The applicant is to submit verification of correction via email to CCLD, by 8/9/2024, via email: Martina.Jimenez@dss.ca.gov

The inspection visit was conducted in Spanish and report was translated in Spanish by LPA Jimenez. 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, Guadalupe Mendoza.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6