566217200-10-10-2024-17-CC-VDIZ-D9WNNY-20241010103730

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566217200
Report Date: 10/10/2024
Date Signed: 10/10/2024 10:37:39 AM

Document Has Been Signed on 10/10/2024 10:37 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	LOZANO FAMILY CHILD CARE		FACILITY NUMBER:	566217200
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS:	DATE:	10/10/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:10 AM
MET WITH:	Julia Lozano		TIME VISIT/ INSPECTION COMPLETED:	11:00 AM

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 10/10/24, Licensing Program Analyst (LPA) Veronica Diaz conducted an announced Pre-licensing inspection. Applicant and LPA toured the facility inside and outside. Applicant was not caring for children at the time of the inspection.

The home is a 4 bedroom, 2 bath, home. The applicant will use the living room, dining room, kitchen, 1 bathroom,backyard and side patio for the childcare. The garage, 4 bedrooms, and 1 bathroom will not be utilized and will be designated off limits for childcare. LPA observed a screened fireplace in the dinning room inaccessible to children. The applicant provided proof of control of property. LPA did not observe any toxins/hazardous items accessible to children. The backyard is fully enclosed with a fenced wall. Cleaning agents and disinfectants are stored under the kitchen sink with child safety lock making it inaccessible to children. Kitchen knives are stored in kitchen drawer with child safety locks inaccessible to children. The bathroom to be used for children in care was observed to be clean and sanitary.

A regulation 2A10BC fire extinguisher was observed applicant stated they purchased last week, applicant was not aware that they needed to keep receipt of purchase, LPA advised applicant that a new one will need to be purchased and to keep the receipt for proof of purchase and documentation . Applicant is reminded to service or purchase the fire extinguisher yearly. LPA had applicant test smoke and carbon monoxide detector which were found operational. All adults in the home are fingerprint cleared. LPA observed the home to be orderly. No bodies of water were observed on site. Applicant stated that there are no guns or ammunition in the home.

Applicant's Pediatric First Aid/CPR certificate is valid until 08/08/26. Applicant's Mandated Reported Training is valid until 5/23/26. Preventative Health and Safety and Nutrition Training was completed on 08/15/24. Childcare orientation was completed on 05/23/24.

Continued on 809-C

SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Veronica Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LOZANO FAMILY CHILD CARE	FACILITY NUMBER: 566217200
	VISIT DATE: 10/10/2024

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
26
27
28
29
30
31
32

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 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. Entrance Checklist was provided to the applicant

LPA issued the applicant updated samples of state required forms to be kept in the children's records. LPA also discussed and provided Guidelines to Safe Sleep and Effects of Lead Exposure leaflets. Applicant was provided information from PIN 20-24-CCP - Recently Approved Safe Sleep Regulations In Effect and LIC 9227 (Infant Sleeping Plan). Applicant was informed that baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours. Applicant was made aware of the responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

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.

Continued on 809-C

SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Veronica Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: LOZANO FAMILY CHILD CARE	FACILITY NUMBER: 566217200
	VISIT DATE: 10/10/2024

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
26
27
28
29
30
31
32

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-andresources/
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

On this date 10/10/24, 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.

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-carelicensing/
subscribe and select the Child Care option to receive email communication.

A small family child care license is pending proof of purchase of the fire extinguisher.

Exit interview conducted and report was reviewed with the applicant, Julia Lazano

SUPERVISORS NAME: Lissete Gonzalez
LICENSING EVALUATOR NAME: Veronica Diaz
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3