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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217134
Report Date: 09/12/2024
Date Signed: 09/16/2024 07:24:46 AM

Document Has Been Signed on 09/16/2024 07:24 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:RUIZ FAMILY CHILD CAREFACILITY NUMBER:
426217134
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
09/12/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:30 PM
MET WITH:Martina RuizTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 9/12/2024 at 1:30 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an announced Pre-licensing Inspection of the above-mentioned home and met with Applicant, Martina Ruiz and partner David Oropeza. LPA informed Applicant of the nature and purpose of the inspection. Applicant proposes the operational hours of a Family Childcare Home (FCCH) from 5:00 AM to 5:00 PM Monday- Friday, Applicant intends to provide care for children 2 to 12 years old.

LPA and applicant toured the home, this is a two story dwelling with four bedrooms and two bathrooms, living room, dining, kitchen, backyard and garage. Accessible areas are living room, 1 bathroom, kitchen and dining areas and backyard. Two bedrooms downstairs, second floor and garage are inaccessible to children. A baby gate was installed at the bottom of the stair case and child safety locks cover all the bedroom doors, and garage door making them inaccessible to children. The bathroom to be used by children in care is observed to be clean and free of toxins. LPA observed cleaning solutions are observed in the garage while medication in the home is kept in the bedroom upstairs. Those items will be inaccessible to children. LPA observed that the backyard was enclosed by 7-foot wooden fence. The surface of the backyard is dirt. LPA observed a play structure in the backyard that includes swings, a climb up ladder and a slide.



Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2024
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 5
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: 426217134
VISIT DATE: 09/12/2024
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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-andresources/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 of infant devices or their purchased equipment.

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.



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.

Continued LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: 426217134
VISIT DATE: 09/12/2024
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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, 9/12/2024, 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.


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.

Continued LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: 426217134
VISIT DATE: 09/12/2024
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LPA observed that the area where the play equipment is situated is not level. Due to uneven surface, the play equipment will not be used until it is moved to a flat , stable surface.
LPA also observed a trampoline, which applicant stated is used by her grandchild. LPA explained the "Trampoline Condition of Use" and the applicant agreed not to use the trampoline during day care hours. It will be locked and ladder will not be in place.

LPA observed a fire extinguisher (2A10BC) in the home which was purchased on 8/1/2024. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The carbon monoxide and detectors were tested at 2:15 PM and found to be operable.

LPA's record review revealed Applicant's Mandated Reporter training was completed on 7/28/2024 (expires on 7/28/2026) and Pediatric CPR/First Aid (EMSA approved) training was completed on 7/20/2024 (expires on (7/20/2026). Applicant completed Preventative Health Training on 8/4/2024, and the CCLD Orientation on 7/22/2024. LPA reminded Applicant of obligation to maintain current training and certifications. Control of Property was reviewed.



Continued LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: 426217134
VISIT DATE: 09/12/2024
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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 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.



Exit interview conducted and report was reviewed with the Applicant Martina Ruiz. The home meets Title 22 Division 12 of California Code of Regulations and Health and Safety Code. License is effective today, 9/12/2024.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024
LIC809 (FAS) - (06/04)
Page: 5 of 5