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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216410
Report Date: 11/10/2022
Date Signed: 12/14/2023 12:59:56 PM

Document Has Been Signed on 12/14/2023 12:59 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:BAUTISTA FAMILY CHILD CAREFACILITY NUMBER:
566216410
ADMINISTRATOR:ROSA BAUTISTAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 816-3371
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
11/10/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Rosa BautistaTIME COMPLETED:
11:30 AM
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On November 10, 2022 at 9:30 am, Licensing Program Analyst (LPA) Susana Martinez conducted an announced pre-licensing inspection for a change of location. Prior license number was 566214976. LPA met with applicant Rosa Bautista and advised her of the reason for the inspection. Prior to entering the home LPA conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. Applicant and LPA toured the home inside and outside. At the time of the inspection there were no children in care.

This two story home has, 3 bedrooms, 3 bathrooms, living room, kitchen, dining room, garage, converted patio and backyard that is fully enclosed by a wooden fence. No bodies of water were present at the time of inspection. The fire place located in the living room is completely covered with foam squares and inaccessible to children in care. Applicant states there are no fire arms in the home. No other adults were observed to be living in the home at the time of the inspection. All rooms are empty except for licensee's.

LPA observed the dinning room and kitchen to be off-limits. Children's safety gates were observed to be placed at the kitchen entrance preventing kids from entering the kitchen area. Door knob safety covers were observed to be on the door leading to the garage, and on the closet located under the stairs. Another safety gate was observed to be located at the bottom of the stairs preventing the children from accessing the second floor of the home.

The rooms that will be used for day-care are the living-room which will mostly be used for napping and eating, the enclosed patio, the backyard, and one restroom located downstairs.

The Oxnard Fire Department granted a fire clearance on 10/31/2022. Dual carbon and smoke detectors were observed throughout the home along with a fire extinguisher that is located in the kitchen.

Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE: DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/10/2022
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: BAUTISTA FAMILY CHILD CARE
FACILITY NUMBER: 566216410
VISIT DATE: 11/10/2022
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LPA observed age-appropriate toys and learning materials inside and outside of the home. Licensee has napping mats along with two cribs readily available. During the tour LPA did not observe any hazardous/ toxic items accessible to children.

Licensee's Pediatric First Aid/CPR certificate is valid through 7/26/2023. Licensee was reminded to renew her certification every two years. Licensee was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com. Current mandated reporter certificate is valid through 9/29/2023. Applicant also showed proof of TB exam dated 10/20/22.

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)/ (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



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 platform.

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.

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, 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.

Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
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: BAUTISTA FAMILY CHILD CARE
FACILITY NUMBER: 566216410
VISIT DATE: 11/10/2022
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep web page at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Entrance Checklist was provided to the applicant.

The home meets Title 22 Division 12 requirements of a Large FCCH. Effective date of license is today, November 10, 2022.

A notice of site visit was given 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 Rosa Bautista.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2022
LIC809 (FAS) - (06/04)
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