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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216249
Report Date: 03/04/2022
Date Signed: 03/08/2022 09:40:02 AM

Document Has Been Signed on 03/08/2022 09:40 AM - 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:GALICIA FAMILY CHILD CAREFACILITY NUMBER:
566216249
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 1DATE:
03/04/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Jaqueline GaliciaTIME COMPLETED:
11:15 AM
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THIS IS AN AMENDED REPORT FOR INSPECTION CONDUCTED ON 3/4/2022 TO OBTAIN LICENSING EVALUATOR SIGNATURES.

This is a change of location, previous facility number 566216026.

On March 4, 2022 at 9:35 AM, Licensing Program Analyst (LPA) Betzayra Cervantes conducted an announced change of location Pre-licensing inspection. LPA spoke to licensee Jaqueline Galicia 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. Licensee was caring for her own infant at the time of the inspection.

On February 18, 2022, the Ventura County Fire Department conducted a fire inspection. Fire clearance approval for the large FCCH was granted on 02/18/2022. The home is a 2 bedroom, 1 bath, single story home. The licensee will be utilizing the living room, dining room, kitchen, one bathroom, and sideyard for daycare. The 2 bedrooms are off limits and made inaccessible to children in care with knob covers. 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 observed the washer and dryer located in the bathroom used for children. Licensee has locks on the appliances and will ensure that they remain inaccessible to children at all times. LPA observed age appropriate toys and furnishings available for children in care in good condition and free of hazards. In the side yard, the children's play area was observed free of hazards and appropriate toys and furnishings are accessible to children in care. LPA observed that outdoor areas are fully enclosed.

LPA did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher was observed in the kitchen with a purchase date of 10/12/2021. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA had licensee test smoke and carbon monoxide detectors in the home and were found operational. All adults in the home are fingerprint cleared.

Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Betzayra Cervantes
LICENSING EVALUATOR SIGNATURE: DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/04/2022
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: GALICIA FAMILY CHILD CARE
FACILITY NUMBER: 566216249
VISIT DATE: 03/04/2022
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THIS IS AN AMENDED REPORT FOR INSPECTION CONDUCTED ON 3/4/2022 TO OBTAIN LICENSING EVALUATOR SIGNATURES.

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. Licensee's Pediatric First Aid/CPR certificate is valid until 04/16/2023. Licensee's Mandated Reported Training certificate is valid until 06/03/2022. LPA verified control of property through Rental Agreement review. The Licensee states that there are no firearms in the home.

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/inspection-process.

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.

LPA reviewed COVID-19 guidelines/resources with licensee (RAST Technical Assistance Visit completed). LPA also reminded licensee to continue monitoring the CCLD website for COVID-19 updates and guidance. LPA observed COVID-19 posters in FCCH. Licensee plans to continue following pre-screening checks, promoting prior hand washing and continuously disinfecting throughout the day.



No deficiencies cited during this visit. License to operate a Large Family Child Care facility is effective today 03/04/2022. Once licensed, the licensee is required to comply with the terms and limitations stated on the license.

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

Exit interview conducted and report was reviewed with the licensee, Jaqueline Galicia.

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

DATE: 03/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2022
LIC809 (FAS) - (06/04)
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