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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566208824
Report Date: 01/25/2024
Date Signed: 01/25/2024 02:54:16 PM

Document Has Been Signed on 01/25/2024 02:54 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 FAMILY CHILD CAREFACILITY NUMBER:
566208824
ADMINISTRATOR:MARIA MENDOZAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 437-9486
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
01/25/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Maria MendozaTIME COMPLETED:
03:15 PM
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On January 25. 2024 AM, Licensing Program Analysts (LPAs) Laura Villanueva and Aaliyah Zendejas made an unannounced visit to conduct a Required - 3 Year Inspection. LPAs met with licensee, Maria Mendoza and explained the purpose of the inspection. LPAs and licensee toured the interior and exterior of the home. Licensee and assistants were caring for 7 children at the time of the inspection.

The home is a 4 -bedroom, 2-bath 1- story home. The licensee uses the living room, family room, dining area, kitchen, 1-bathroom and the backyard for childcare. The 4- bedrooms, 1-bathroom, and garage are off limits and are inaccessible to children in care. LPAs observed a screened fireplace in the family room making it inaccessible to children in care. LPAs observed age appropriate toys, teaching materials, and furnishings available for children in care in good condition and free of hazards. Licensee has a secured fence in the backyard. All adults in the home are fingerprint cleared. LPAs did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher was observed in the kitchen with a service date of 01/03/2024. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee states that there are no firearms and ammunition in the home.

LPAs observed the home to be orderly. No bodies of water were observed on site. Detergents and cleaning compounds are stored on a high cabinet shelf 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. LPAs observed a carbon monoxide in the kitchen and smoke detector in the playroom. Smoke detector was tested on January 16, 2024. .

Licensee's Pediatric First Aid/CPR certificate is valid until 09/29/2025. AB 1207 Mandated Reporter Training certificate is valid until 09/09/2025. Licensee last completed an emergency disaster drill on 01/05/2024.. 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 LPAs observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

CONTINUED ON 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/25/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: MENDOZA FAMILY CHILD CARE
FACILITY NUMBER: 566208824
VISIT DATE: 01/25/2024
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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/.

LPAs discussed the safe sleep regulations with licensee [or facility representative] 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. LPAs 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.

CONTINUED LIC809C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: MENDOZA FAMILY CHILD CARE
FACILITY NUMBER: 566208824
VISIT DATE: 01/25/2024
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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.

During the exit interview, the LICENSEE ****, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days. No deficiencies cited today.

Exit interview conducted and report was reviewed with the licensee, Maria Mendoza.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 01/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/25/2024
LIC809 (FAS) - (06/04)
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