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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215797
Report Date: 06/16/2022
Date Signed: 06/16/2022 01:19:28 PM

Document Has Been Signed on 06/16/2022 01:19 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:PEREZ FCC AKA RIVERPARK CHILD CARE HOMEFACILITY NUMBER:
566215797
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
06/16/2022
TYPE OF VISIT:Case Management - OtherANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Yuliana PerezTIME COMPLETED:
01:40 PM
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On June 16, 2022 at 12:00PM, Licensing Program Analyst (LPA) Betzayra Cervantes conducted an announced visit for the purpose of performing a Case Management- Licensee Initiated inspection. Prior to entering the facility, LPA spoke to licensee Yuliana Perez and conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA discussed the nature and purpose of the inspection. Licensee and LPA toured the facility inside and outside. There were no children in care at the time of the inspection.

On 06/06/2022, licensee called CCLD to request that her license be reactivated. The home is a four bedroom, three bath, two story home. The Licensee uses the living room, dining room, one bedroom which is the main playroom, one bathroom, and backyard for day-care. On the first floor, the laundry room, toy closet, pantry, and garage are off limits to children in care. LPA observed a child safety gate at the bottom of the stairs making the second floor inaccessible. The second floor is not used for day-care and is off limits to children. LPA observed age appropriate toys, teaching materials and furnishings in good condition and free of hazards. All adults in the home are fingerprint cleared. LPA did not observe any toxins/hazardous items accessible to children. LPA observed a 3A40BC fire extinguisher in the playroom with a purchase date of 06/06/2022. Licensee is reminded to service or purchase the fire extinguisher yearly. Licensee has a secured fence in the backyard and age appropriate toys for children in care, found in good condition and free of hazards.

LPA observed the home to be orderly. No bodies of water were observed on site. No toxins nor hazards are accessible to children in care. Detergents and cleaning compounds are stored out of reach of children. The bathroom to be used for children in care was observed to be clean and sanitary. LPA had licensee test the dual smoke and carbon monoxide detectors in the home which were found operational.

CONTINUED ON 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Betzayra Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2022
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: PEREZ FCC AKA RIVERPARK CHILD CARE HOME
FACILITY NUMBER: 566215797
VISIT DATE: 06/16/2022
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Licensee's Pediatric First Aid/CPR certificate is valid until 03/15/2024. Licensee's Mandated Reported Training certificate is valid until 05/27/2024. Licensee states that there are no firearms and ammunition in the home. All required forms including Notification Of Parent's Rights are prominently posted for parent's or authorized representatives to view.

Incidental Medical Services (IMS) policy 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 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: http://www.ada.gov/childqanda.htm

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.

License to operate a Small Family Child Care facility is effective today, 06/16/2022. Once licensed, the licensee is required to comply with the terms and limitations stated on the license.

Exit interview conducted and report was reviewed with the licensee, Yuliana Perez.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Betzayra Cervantes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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