426217153-10-30-2024-17-CC-SMAZ-DAJRYT-20241030132653

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426217153
Report Date: 10/30/2024
Date Signed: 10/30/2024 01:27:03 PM

Document Has Been Signed on 10/30/2024 01:27 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:	MUNIZ FAMILY CHILD CARE		FACILITY NUMBER:	426217153
ADMINISTRATOR/ DIRECTOR:	MUNIZ, ANTOINETTE & MARIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 931-4126
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	10/30/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:00 PM
MET WITH:	Antoinette Muniz		TIME VISIT/ INSPECTION COMPLETED:	01:30 PM

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This is a change of location, previous license number was 426216015. Note, previous license had co-licensee, Maria Muniz, who no longer resides at the previous location nor resides at this location. Licensee will be the sole provider at this location.

On 10/30/2024 at 12:15 PM, Licensing Program Analyst (LPA) Susana Martinez conducted an announced Pre-licensing inspection for a change of location of a Large Family Child Care Home (FCCH). LPA met with Licensee Antoinette Muniz, and discussed the purpose of today’s inspection. Together with the Licensee, LPA toured the inside and outside of the home. At the time of inspection there were no children in care and no adults in the home. Licensee plans to operate Mon- Fri 6:30 AM- 5:30 PM and care for children 0-12 years of age. Licensee denies having guns/ammunition in the home.

Applicant requested a change of location for a large family childcare license. The facility is a one-story home consists of three (3) bedrooms, one (1) bathroom, living room, kitchen, dining area, laundry room, detached garage and enclosed outdoor yard. Licensee plans to use the living room, dining area, one (1) bathroom, one (1) bedroom and enclosed outdoor yard for day-care use. Meanwhile, the two (2) bedrooms, garage, laundry room and kitchen will be off-limits to children in care. Bedrooms will have child proof locks to prevent children from having access. LPA notes, a small baby gate is located at the entrance of the kitchen which also leads to the laundry room, making it inaccessible to children in care.

LPA observed age-appropriate furnishings and play equipment for children to play with. Licensee has cots and pack-n-plays readily accessible for children to nap on. The bathroom is free of hazardous items. LPA observed a face heater located in the living room and in the hallway. LPA advised Licensee that heaters need to be made inaccessible to children. Licensee states she will purchase covers and install them. The backyard is completely fenced. LPA notes a glass panel located on the left-side of the yard, Licensee states she will have it removed as soon as possible.

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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MUNIZ FAMILY CHILD CARE	FACILITY NUMBER: 426217153
	VISIT DATE: 10/30/2024

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Applicant's Pediatric First Aid/CPR certificate is valid through 3/2/2026. 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 11/27/2024.

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 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.

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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MUNIZ FAMILY CHILD CARE	FACILITY NUMBER: 426217153
	VISIT DATE: 10/30/2024

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One (1) adult lives in the home. 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.

Because the licensee rents/leases the home, proof of landlord notification is required. The LPA 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).

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, 10/30/2024, 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.

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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MUNIZ FAMILY CHILD CARE	FACILITY NUMBER: 426217153
	VISIT DATE: 10/30/2024

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LPA reviewed with licensee 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.

A fire clearance was granted by the Santa Maria Fire Department on 10/17/2024.

Licensure of the Large FCCH is pending the following:

- Removal of glass sheet located in the backyard.

- Making open-faced heaters inaccessible to children.

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 licensee Antoinette Muniz.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024

LIC809 (FAS) - (06/04)

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