426217486-5-30-2025-17-CC-GNEE-DH6PFV-20250530111723

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426217486
Report Date: 05/30/2025
Date Signed: 05/30/2025 11:18:53 AM

Document Has Been Signed on 05/30/2025 11:18 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	PORTELA FAMILY CHILD CARE		FACILITY NUMBER:	426217486
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	05/30/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:29 AM
MET WITH:	Paula Portela		TIME VISIT/ INSPECTION COMPLETED:	11:09 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	This is a change of location, previous facility number is 426216937 On 5/30/2025 Licensing Program Analyst (LPA) German Negrete conducted an announced Prelicensing Inspection for a change of location to the above-mentioned residence. LPA met with Applicant, Paula Portela. LPA informed Applicant of the nature and purpose of the inspection. LPA notes 1 child present at the time of the inspection (Applicant's child) in addition to the Applicant's husband. Applicant informed LPA the intention to operate their Family Child Care Home (FCCH) Monday through Friday from 5:30 AM until 5:00PM. The Applicant also informed LPA of the intention to provide care for children 0 years to 13 years of age. LPA toured the interior and exterior of the residence with the Applicant. The residence is a one story house consisting of 3 bedrooms and 2 bathrooms. The home's living room, kitchen, dining room, hallway bathroom#1, and backyard will be utilized for child care. The remainder of the home is excluded from childcare services: all bedrooms, front yard, garage, hallway bathroom#2. Importantly to note, all areas that are inaccessible are made secure by child safety gates and locks. All accessible and inaccessible areas were toured thoroughly. LPA observed the accessible day care areas to have proper spacing and ventilation for children in care due to Air conditioning system. LPA observed a fireplace near the kitchen of the home. The fire place has a enclosed child proof gate, making it inaccessible to children in care. (CONT. LIC 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: PORTELA FAMILY CHILD CARE	FACILITY NUMBER: 426217486
	VISIT DATE: 05/30/2025

NARRATIVE

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The hallway bathroom#1 of the residence was observed to be clean and free of toxins. The bathroom has
cabinets that contain common and non-hazardous bathroom items. Importantly to note, hallway bathroom#2 area is made inaccessible via a child safety gate and lock.

Sharps, medication, and some cleaning supplies are stored in elevated kitchen cabinets( at least 5 feet).

LPA observed a required fire extinguisher (3A:40B:C) in the home which was last serviced on 3/5/2025. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has multiple smoke and carbon monoxide detectors throughout the home. A smoke detector was tested at 9:39AM, while a carbon monoxide detector was tested at 9:41AM. Both detectors were found to be operational.

As mentioned prior, the backyard will be accessible for children in care. This area consists of mostly soft grass surface flooring and is afforded shade by neighboring trees. The backyard is fully enclosed by wood fencing throughout. No bodies of water was observed on the property.

LPA record review revealed Applicant completed Preventative Health training on 04/13/2023. Furthermore, Applicant completed Mandated Reporter training on 1/16/2024 and applicant's assistant (husband) completed mandated reporter training on 4/20/2024. Applicant completed Pediatric CPR/First Aid training (EMSA approved) on 2/18/2024. LPA reminded Applicant of the obligation to maintain current training and certifications. Because the Applicant rents the residence, Applicant provided control of property (rental agreement) LPA verified/reviewed control of property. The Property Owner/Landlord Notification form (LIC9151) and confirmed it was provided to the property owner/landlord. The Applicant also obtained a signed Property Owner/Landlord Consent form (LIC 9149). LPA notes no firearms or ammunition are stored on site.

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.

(CONT. LIC 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

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: PORTELA FAMILY CHILD CARE	FACILITY NUMBER: 426217486
	VISIT DATE: 05/30/2025

NARRATIVE

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LPAs 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.

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. Applicant is willing to provide IMS Services depending on the need.

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 athttps://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

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, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated. (CONT. LIC 809-C, Page 4)

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

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: PORTELA FAMILY CHILD CARE	FACILITY NUMBER: 426217486
	VISIT DATE: 05/30/2025

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On this date, 5/30/25, 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.

Today 5/30/2025, the home does meet Tittle 22 CCR for a small Family Child Care Home License.

The Applicant's small License will be pending managerial review.

The report was read and reviewed with Applicant Paula Portela.

A notice of site visit was given to the Applicant and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

NAME OF LICENSING PROGRAM MANAGER: Ana Tolentino
NAME OF LICENSING PROGRAM ANALYST: German Negrete
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/30/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025

LIC809 (FAS) - (06/04)

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