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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216534
Report Date: 04/11/2023
Date Signed: 04/11/2023 11:35:56 AM

Document Has Been Signed on 04/11/2023 11:35 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:CARILLO FCC AKA KINGDOM KIDS DAYCAREFACILITY NUMBER:
566216534
ADMINISTRATOR:VERONICA CARRILLOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 212-2098
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
04/11/2023
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Veronica CarrilloTIME COMPLETED:
11:50 AM
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This is a change of location pre-licensing inspection, previous facility number 566216002

On 4/11/2023 at 9:40 AM, Licensing Program Analyst (LPA) Austin Rios conducted an announced change of location Pre-licensing inspection. Oxnard Fire department approved large capacity on 3/27/2023. LPA met with licensee Veronica Carrillo and LPA discussed the nature and purpose of the inspection. The home is a four bedroom, two and a half bathrooms.

LPA toured the home with licensee. The licensee will be using the living room, one bathroom, and the backyard for the daycare. LPA observed a gate in the hallway making the family room and kitchen off limits. Licensee also had a gate in front of the stairs. There were no children in care at the time of the inspection other then licensees own child. LPA did not observe any toxins/hazardous items accessible to children. Toxins are locked away and inaccessible to children in care.

A regulation 2A10BC fire extinguisher which was purchased in February 2023 was observed in the kitchen readily accessible. Applicant is reminded to service or purchase the fire extinguisher yearly.

Cont. on 809-C
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE: DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/11/2023
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: CARILLO FCC AKA KINGDOM KIDS DAYCARE
FACILITY NUMBER: 566216534
VISIT DATE: 04/11/2023
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LPA observed and tested the smoke and carbon monoxide detectors in the home. Licensee advised that there are no firearms in the home. There are age appropriate toys and day-care equipment in the home. The back yard has age appropriate toys and play structures. Licensee First Aid/CPR certificate is valid until 5/2023. Licensee was advised to renew CPR training next month. .

LPA verified SB 792 (child care employee and volunteer: Immunization and Tuberculosis Requirements). Licensee was informed walkers, bouncers, and any similar objects that restricts child movements is prohibited from licensed facilities. LPA spoke with licensee regarding safe sleep regulations.

Licensee is granted licensed for large FCCH effective today 4/11/2023.

Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Austin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC809 (FAS) - (06/04)
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