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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566200634
Report Date: 12/10/2024
Date Signed: 12/10/2024 02:04:25 PM

Document Has Been Signed on 12/10/2024 02:04 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:RUVALCABA FAMILY DAY CARE HOMEFACILITY NUMBER:
566200634
ADMINISTRATOR/
DIRECTOR:		MARGARITA RUVALCABAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 486-6549
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
12/10/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:25 PM
MET WITH:Margarita RuvalcabaTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
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On December 10, 2024 12:25 PM, Licensing Program Analyst (LPA) Laura Carone made an unannounced visit to conduct a Required - 3 Year Inspection. LPA met with licensee, Margarita Ruvalcaba and explained the purpose of the inspection. LPA and licensee toured the interior and exterior of the home. Licensee was caring for 2 children at the time of the inspection.

The home is a 3--bedroom, 2-bath 2-story home. Entrance to the studio on the second floor is through the outside of the house. Tenants are residing in the studio. Residents are fingerprint cleared. The licensee uses the living room, dining area, kitchen, family room, 1- bathroom and the front yard for childcare. The 3-bedrooms, 1-bathroom, and garage are off limits and are inaccessible to children in care. LPA observed a screened fireplace in the family room making it inaccessible to children in care. Licensee has a secured fence in the backyard. LPA did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher was observed mounted in the kitchen with a purchase date of 08/22/2024. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee states that there are no firearms and ammunition in the home.

LPA observed the home to be orderly. No bodies of water were observed on site. Detergents and cleaning compounds are stored in a locked pantry in the kitchen keeping items out of reach of children. The bathroom to be used for children in care was observed to be clean and sanitary. LPA observed a carbon monoxide and smoke alarm detector mounted in the living room.

Licensee's Pediatric First Aid/CPR certificate is valid until 07/31/2026. AB 1207 Mandated Reporter Training has not been completed. LPA provided licensee a pamphlet with instructions on accessing the online course. Licensee last completed an emergency disaster drill on 07/08/2024. All required forms including Notification of Parent's Rights are prominently posted for parent's or authorized representatives to view. A roster of children in care was observed current and complete. All children records were reviewed, and LPA observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

CONTINUED ON LIC809-C

SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Laura Carone
LICENSING EVALUATOR SIGNATURE: DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/10/2024
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: RUVALCABA FAMILY DAY CARE HOME
FACILITY NUMBER: 566200634
VISIT DATE: 12/10/2024
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To improve the quality and value of the new inspection process, a survey may be sent to the
email address provided. Please complete the survey and share your inspection experience. If
you have any questions regarding the process or CARE tools, please send email inquiries to
inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its
tools and methods, please visit the Program website at
www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

Licensee was reminded that all adults 18 and over living or working in the home, 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 of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

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-andresources/


safe-sleep as an additional resource.

LPA also informed licensee 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.

Licensee was informed of the MyChildCarePlan.org website; 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.

CONTINUED ON LIC809-C

SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Laura Carone
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
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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: RUVALCABA FAMILY DAY CARE HOME
FACILITY NUMBER: 566200634
VISIT DATE: 12/10/2024
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During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A type B deficiency was issued. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Margarita Ruvalcaba.

SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Laura Carone
LICENSING EVALUATOR SIGNATURE:

DATE: 12/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2024
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Document Has Been Signed on 12/10/2024 02:04 PM - It Cannot Be Edited


Created By: Laura Carone On 12/10/2024 at 01:21 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: RUVALCABA FAMILY DAY CARE HOME
FACILITY NUMBER: 566200634

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in 1 out of 1 persons which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/10/2025
Plan of Correction
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LPA provided licensee a pamplet with instructions to access the online training. Licensee will complete training and submit the certificate to LPA via email or US mail.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Lissete Gonzalez
LICENSING EVALUATOR NAME:Laura Carone
LICENSING EVALUATOR SIGNATURE:
DATE: 12/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/10/2024


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