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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216301
Report Date: 07/18/2023
Date Signed: 07/18/2023 05:28:42 PM

Document Has Been Signed on 07/18/2023 05:28 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:CABRERA FAMILY CHILD CAREFACILITY NUMBER:
566216301
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 6DATE:
07/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:27 AM
MET WITH:Julia CabreraTIME COMPLETED:
10:56 AM
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On July 18th, 2023, at 9:27AM Licensing Program Analyst (LPA) Rosie Breault conducted an unannounced Annual/Random inspection. LPA met with licensee Julia Cabrera and advised the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. At the time of the inspection there six (6) children present. In addition, licensee applied for a Large Family Child Care Home (FCCH) and application will be reflected in inspection report.

LPA observed all required documents posted in a prominent location. This is a two story FCCH and children have access to first level only consisting of: one (1) living room, one (1) playroom, one (1) bathroom, and outdoor area. Kitchen is inaccessible by gate. Garage, closet, and one (1) bedroom by a locks on doors. Upstairs consists of (3) bedrooms and two (2) bathrooms which have been made inaccessible by a locked gate at the bottom of the stairs. LPAs observed all toxins, poisons, sharps, tools, and combustibles elevated/gated/locked and inaccessible to children’s reach. LPA observed age-appropriate toys and equipment readily accessible to children in care. Children nap on mats which are cleaned daily.

Outdoor play area provides ample shade and age-appropriate toys, fencing, and soft surfaces. No bodies of water are present.

LPAs observed a 2A10BC fire extinguisher with purchased date of 5/12/2023 mounted on the wall in the next to kitchen readily accessible. Licensee advised to ensure the fire extinguisher is serviced or a new one in purchased every year. The last emergency drill was conducted on 7/14/2023. Combination carbon monoxide/smoke detector was tested at 9:54AM and functioning at the time of the inspection. First aid kits are available. Licensee stated no firearms or ammunition are present on the property. Licensee stated incidental medical services are not being provided at this time.

CONTINUED ON LIC809C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE: DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/18/2023
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: CABRERA FAMILY CHILD CARE
FACILITY NUMBER: 566216301
VISIT DATE: 07/18/2023
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LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Licensee’s Pediatric CPR/First-Aid certificate is current and valid until 5/2025. LPAs verified current Mandated Reported Certificates which expires 7/5/2025.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home 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 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 [facility representative] 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.

Oxnard Fire Department inspected on 6/19/2023 and cleared home for Large FCCH license with capacity of 14.

This home meets Title 22 Division 12 of a Large Family FCCH effective today 7/18/2023. Exit interview conducted, report was reviewed with the licensee, copy provided.
THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:

DATE: 07/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2023
LIC809 (FAS) - (06/04)
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