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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215766
Report Date: 07/13/2022
Date Signed: 07/13/2022 12:09:43 PM

Document Has Been Signed on 07/13/2022 12:09 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:SANCHEZ FAMILY CHILD CAREFACILITY NUMBER:
566215766
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
07/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Melissa SanchezTIME COMPLETED:
12:28 PM
NARRATIVE
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On July 13, 2022 at 10:15 AM Licensing Program Analyst (LPA) Austin Rios conducted an unannounced annual inspection. LPA met with licensee Melissa Sanchez 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 six children in care at the time of the inspection.

The licensee uses the family room, dining room, kitchen, one restroom, and backyard for the day-care. LPA observed a gates preventing children from having access to the upstairs bedrooms. The garage door was locked.. Licensee has a pool with a gate that surrounds the pool that is at least five feet high and gate was locked. Licensee states that there are no firearms and ammunition in the home. In the family room, LPA observed a fireplace with a glass screen front of it preventing children from having access.

LPA observed during the inspection a liquid clorox bottle under the kitchen sink with no lock on the cabinet and observed a lysol liquid bottle under the bathroom sink in the bathroom that the children use with no lock on the cabinet as well, California Code of Regulation, Title 22 Division 12 regulation is being cited 102417(g)(4) operation of a family child care home type A deficiency is being cited on the attached LIC 809 D. Licensee is not documenting the fifteen minute check for the infants California Code of Regulation, Title 22 Division 12 is being cited 102425(j)(2) Infant sleep type B deficiency is being cited on the attached LIC 809 D.

Cont. on 809 C.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE: DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2022
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: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 566215766
VISIT DATE: 07/13/2022
NARRATIVE
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The home has a working smoke and carbon monoxide detector. A 2A10BC fire extinguisher was observed in the kitchen with a service date of 5/20/2022. Licensee has a valid Pediatric CPR/First Aid certificate with an expiration date of 6/2023. Licensee has AB 1207 Mandated Reporter Training Certificate on file expiring on 6/21/2023. The last fire drill was conducted in May 2022. All required forms are on a poster board in the dining room. 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 structure in the backyard in good condition and free of hazards.

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 Austin Rios informed licensee Melissa Sanchez that this report dated 7/13/2022 document Title 22 Division 12 102417(g)(4)Type A citation shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.



Also, LPA Austin Rios informed the licensee to provide a copy of this licensing report dated 7/13/2022 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. LPA also provided licensee with appeal rights.

Cont. on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
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: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 566215766
VISIT DATE: 07/13/2022
NARRATIVE
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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 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee Melissa Sanchez

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/13/2022 12:09 PM - It Cannot Be Edited


Created By: Austin Rios On 07/13/2022 at 11:41 AM
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: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 566215766

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above as there was a liquid clorox bottle under the kitchen sink with no lock at the time of the inspection and LPA identified a liquid lysol bottle under the bathroom sink with no lock which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 07/13/2022
Plan of Correction
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Licensee removed the bottles during the inspection and placed them out of the reach of the children. Licensee stated she will keep these cleaning products in the garage.
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:Ana Tolentino
LICENSING EVALUATOR NAME:Austin Rios
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2022


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/13/2022 12:09 PM - It Cannot Be Edited


Created By: Austin Rios On 07/13/2022 at 11:41 AM
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: SANCHEZ FAMILY CHILD CARE
FACILITY NUMBER: 566215766

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(2)(B)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following: Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above because licensee is checjing on the infants but is not documenting the fifteen minute check which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 07/20/2022
Plan of Correction
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Licensee will send proof of infant safe sleep chart documented with times that the infant was checked on to LPA Rios by 7/29/2022 and will continue to document 15 minute checks for infants.
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:Ana Tolentino
LICENSING EVALUATOR NAME:Austin Rios
LICENSING EVALUATOR SIGNATURE:
DATE: 07/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/13/2022


LIC809 (FAS) - (06/04)
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