566216752-11-2-2023-17-CC-GGOZ-CX7SPZ-20231102140357

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566216752
Report Date: 11/02/2023
Date Signed: 11/02/2023 02:04:08 PM

Document Has Been Signed on 11/02/2023 02:04 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	FLORES FAMILY CHILD CARE		FACILITY NUMBER:	566216752
ADMINISTRATOR:	PATRICIA FLORES		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 663-1763
CITY:	OXNARD	STATE: CA	ZIP CODE:	93036
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	11/02/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Patricia Flores		TIME COMPLETED:	02:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On November 2, 2023 Licensing Program Analyst Giovani Gonzalez conducted an announced Prelicensing inspection at the above-mentioned residence. LPA met with Applicant Patricia Flores and informed them the purpose of the inspection. Applicant informed LPA the intention to maintain operating hours of the Family Child Care Home (FCCH) Monday-Sunday 24 hours a day. LPA notes that 1 foster child was present at the time of the inspection. LPA in the company of the Applicant toured the interior and exterior of the residence in its entirety. The residence is a 3 bedroom, 1 bathroom single story home. The home's living room and bathroom will be used for child care purposes while the garage and remainder of the home is excluded from care. LPA observed the home to be clean and orderly. The home has sufficient spacing and ventilation for children in care. The home's kitchen was observed to be accessible, however all low cabinets and drawers were observed to be secured with child proof locks. Cleaning compounds were observed to be stored in a cabinet under the sink which is secured by a child safe lock. Sharps are stored in an elevated cabinet in the kitchen beyond the reach of children. Medication is stored in an elevated cabinet in the kitchen and elevated surface in an inaccessible bedroom. The bathroom to be used for children in care was observed to be clean and free of toxins. LPA observed a regulation fire extinguisher (2A10BC) in the home which was purchased on 10/24/2023. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has numerous combination smoke and carbon monoxide detectors. A combination smoke and carbon monoxide detector was observed to be operable at 12:45PM. The home's backyard was observed to be enclosed by a wooden gates. LPA observed side gates to be CONTINUED PAGE 2

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 566216752
	VISIT DATE: 11/02/2023

NARRATIVE

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secured. LPA observed Applicant has farm animals in the backyard that are separated from the children's areas with a gate that remains secured.

LPA's record review revealed Applicant's Mandated Reporter Training (AB1207 compliant) was completed on 9/25/2023 (expires 9/25/2025 ) and Pediatric CPR/First Aid (EMSA approved) was completed 2/25/2022 (expires 2/25/2024). LPA reminded Applicant the obligation to maintain current training and certifications. Applicant completed Preventative Health Training 3/10/2022. Fire Clearance was granted on 10/24/2023. LPA reviewed Applicant's control of property document (Mortgage Statement). Applicant does not have liability insurance for the home. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282). Applicant informed LPA no firearms or ammunition are on site.

LPA reviewed with Applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted

Applicant 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, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

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) or (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.

LPA discussed the safe sleep regulations with applicant 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 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.
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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: FLORES FAMILY CHILD CARE	FACILITY NUMBER: 566216752
	VISIT DATE: 11/02/2023

NARRATIVE

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On this date, 10/24/2023, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Exit interview conducted and report was reviewed with the Applicant Patricia Flores. The home meets Title 22 Division 12 requirements of a Large FCCH License. Effective date of license will be noted as the present, 11/2/2023.

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 platforms.
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.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

LIC809 (FAS) - (06/04)

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