566215676-2-23-2024-17-CC-STOE-D2R2R6-20240223163659

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215676
Report Date: 02/15/2024
Date Signed: 02/23/2024 04:37:50 PM

Document Has Been Signed on 02/23/2024 04:37 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:	ORTIZ FAMILY CHILD CARE		FACILITY NUMBER:	566215676
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	02/15/2024
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:27 AM
MET WITH:	Juana Ortiz		TIME COMPLETED:	10:18 AM

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On 02/15/2024 Licensing Program Analysts (LPAs) German Negrete and Sylvia Ceja conducted an unannounced Case Management inspection for a change of capacity. During the inspection, the LPAs met with Licensee, Juana Ortiz and explained the purpose and scope of the visit. Licensee was observed caring for one child in the family child care home(FCCH) during the inspection.

Licensee submitted an application for increase in capacity on 07/14/2023. The home is a one story home that consists of four bedrooms, two restrooms, one living room, one family room, dining room, garage and outdoor play area that is fenced off. The areas used for day-care are as followed; the family room, living room, kitchen, one restroom.

The off limits areas consist of four bedrooms, 1 restroom (master), garage and side yard and the backyard. LPAs observed locks on the door knobs on the bedrooms and garage door making the bedroom and garage inaccessible to day-care children. The knives and medication are stored in kitchen cabinets at 5 feet or higher making these items inaccessible to children in care. The children are escorted to the day care area by the parents/or Licensee when they arrive to the FCCH.

LPAs observed that the FCCH to be clean, orderly there is be well ventilated for the children in care. LPAs observed cleaning compounds in a locked cabinet in the kitchen making them inaccessible to children in care. Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

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: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 566215676
	VISIT DATE: 02/15/2024

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The restroom to be used for children in care was observed to be clean and free of toxins. LPAs observed that home has age appropriate chairs, tables, equipment, toys and other materials for child care activities.

LPAs and Licensee toured the backyard which is completely fenced. Licensee states she does not use the backyard for the day care children. Licensee takes the children in care to a park across the street from the FCCH. Licensee states the sliding and side door leading to the backyard are locked during day care. LPAs observed a fountain approximately 3 feet wide in the backyard which was secured on top with fencing and a hot tub secured and locked.

Licensee was reminded, No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility

LPAs observed a regulation 4A80BC fire extinguisher in the FCCH at the time of the inspection that was serviced on 11-2-2023 . Licensee is reminded to service or purchase the fire extinguisher yearly. LPAs observed the smoke and carbon monoxide detectors in the home and Licensee stated are functioning at the time of the inspection. The carbon monoxide and fire extinguisher was tested at 9:50am

Licensee is current with immunization required per SB792. The Licensee completed the Orientation on 01/15/2002. Licensee Pediatric First Aid/CPR certificate is valid until 09-1-2024 . Licensee Mandated Reporter Training certificate is valid until 06/24/2025.

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, Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 566215676
	VISIT DATE: 02/15/2024

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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.

On this date, 02/14/2024, 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 addresses. 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.

Licensee 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.

LPA reviewed with Licensee 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. Entrance Checklist was provided to the applicant.

Continued on 809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 566215676
	VISIT DATE: 02/15/2024

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Licensee 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, 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 Child Care Center. 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) 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.

Licensee submitted control of property through taxes. LPA's verified control of property documents to be correct. Fire Safety inspection clearance was granted on 1/16/2024. During today's inspection, no deficiencies were cited. FCCH meets the requirement of Title 22 Division 12 for a large license effective today, 2/15/2024. There is a firearms separate from the ammunition and both the ammo and fire-arm are stored in a locked safe.

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

Exit interview conducted and report was reviewed with the Licensee, Juana Ortiz.

Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: ORTIZ FAMILY CHILD CARE	FACILITY NUMBER: 566215676
	VISIT DATE: 02/15/2024

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

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024

LIC809 (FAS) - (06/04)

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