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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566212544
Report Date: 09/23/2021
Date Signed: 09/23/2021 12:45:43 PM

Document Has Been Signed on 09/23/2021 12:45 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:LEMOS FCC AKA BECKY'S DAYCAREFACILITY NUMBER:
566212544
ADMINISTRATOR:REBECCA LEMOSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 509-6956
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
09/23/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Rebecca LemosTIME COMPLETED:
12:53 PM
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On September 23, 2021 at 11:15 AM Licensing Program Analyst (LPA) Austin Rios conducted an unannounced annual inspection. LPA conducted Covid-19 screening questions prior to entering the home. LPA met with licensee Rebecca Lemos and discussed the nature and purpose of the inspection. Together both licensee and LPA conducted a tour of the home inside and outside. There was five children in care at the time of the inspection.

The home is a single story and licensee uses the play room, one restroom, and backyard for the day-care. LPA observed a gate in front of the hallway preventing children from having access to to the bedrooms. LPA also observed a gate in front of the kitchen preventing children from having access. There are no bodies of water in the home. Licensee states that there are no firearms and ammunition in the home. LPA did not observe toxins/hazards accessible to children in care. In the living room, LPA observed a fireplace with a shelf in front of it preventing children from having access. There are age appropriate toys and furniture readily accessible to children. The backyard is fully enclosed with a fenced wall. Licensee has age appropriate toys and play structures in the backyard in good condition and free of hazards. LPA observed there was ample amount of shade available for children.

The home has a working smoke and carbon monoxide detector. A 2A10BC fire extinguisher was observed in the family room with a purchase date of 9/23/2021. Licensee has CPR waiver attestation form posted. Licensee has AB 1207 Mandated Reporter Training Certificate on file.

Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2021
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: LEMOS FCC AKA BECKY'S DAYCARE
FACILITY NUMBER: 566212544
VISIT DATE: 09/23/2021
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All required forms are prominently posted for parent's or authorized representatives to view at the entrance of the facility. A roster of children in care was observed current and complete. A sampling of children's records were reviewed and found complete. LPA observed Identification and Emergency Notification forms (LIC 700). Licensee has a dog and all vaccines are current.

LPA spoke with licensee regarding safe sleep regulations and provided licensee with safe sleep forms.

Incidental Medical Services (IMS) was discussed. Licensee states currently no children with IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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:http://www.ada.gov/childqanda.htm

No deficiencies were cited during today's visit.



THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021
LIC809 (FAS) - (06/04)
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