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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215238
Report Date: 08/29/2022
Date Signed: 08/29/2022 02:27:57 PM

Document Has Been Signed on 08/29/2022 02:27 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:SANTANA FAMILY CHILD CAREFACILITY NUMBER:
566215238
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
08/29/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:48 PM
MET WITH:Gabriela SantanaTIME COMPLETED:
02:48 PM
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On August 29, 2022 at 12:48 PM Licensing Program Analyst (LPA) Rona Chavez conducted an unannounced annual inspection. LPA met with licensee Gabriela Santana and discussed the nature and purpose of the inspection. LPA asked Covid-19 screening questions prior to entering the home. Together both licensee and LPA conducted a tour of the home inside and outside. There was one child in care at the time of the inspection.

The licensee uses the living room, kitchen, playroom. one restroom, and the front yard for the day-care. LPA observed all required forms prominently posted for parent's or authorized representatives in the living room. Licensee states that there are no firearms and ammunition in the home. LPA did not observe toxins/hazards accessible to children in care. LPA observed a gate at the bottom of the stairs preventing the children from having access to the 2nd floor. There are age appropriate toys and furniture readily accessible to children. The front yard is fully enclosed with a brick and wrought iron fence. Licensee has age appropriate toys and play structures in the front yard in good condition and free of hazards.

The home has working smoke and carbon monoxide detectors. A 2A10BC fire extinguisher was observed in the kitchen with a service date of 8/29/2022. Licensee has a valid Pediatric CPR/First Aid certificate with an expiration date of 3/29/2024. Licensee has AB 1207 Mandated Reporter Training Certificate on file expiring on 07/21/2023. The last fire drill was conducted on 8/29/2022.

Continued on 809-C


SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2022
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: SANTANA FAMILY CHILD CARE
FACILITY NUMBER: 566215238
VISIT DATE: 08/29/2022
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A roster of children in care was observed current and complete. A sampling of children's records were reviewed and found complete. Licensee follows Safe Sleep Regulations and logs 15-minute checks when infant is in care. LPA observed Covid-19 precautionary measures are being followed.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

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 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.

Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMA 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:http://www.ada.gov/childqanda.htm

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022
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: SANTANA FAMILY CHILD CARE
FACILITY NUMBER: 566215238
VISIT DATE: 08/29/2022
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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Report was reviewed with licensee and provided a copy.

An exit interview was conducted with Licensee Gabriela Santana.

A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022
LIC809 (FAS) - (06/04)
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