Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207818
Report Date: 02/08/2016
Date Signed: 02/08/2016 02:47:53 PM

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:BRAGG FAMILY CHILD CAREFACILITY NUMBER:
426207818
ADMINISTRATOR:GABRIELA BRAGGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 346-6402
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 3DATE:
02/08/2016
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:03 PM
MET WITH:Gabriela BraggTIME COMPLETED:
03:00 PM
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(1) Licensing Program Analyst (LPA) Ana Tolentino made an unannounced visit for the purpose of conducting a Random Annual Visit. The purpose of the visit was discussed with the Licensee Gabriela Bragg and together we tour the home inside and outside.

Their is a spa in the home, it is made inaccessible to the children by the locked covering and fencing gate. Licensee states firearms are not kept in the home. Licensee stated that all adults residing in the home have a criminal record clearance. Cleaning products and all potentially hazardous items are stored inaccessible to children. The fireplace is properly screened. Fire extinguisher last serviced on 11/16/15. There is a working smoke detector and carbon monoxide detector in the home.

The home is clean and orderly. The home provides safe toys, play equipment and materials. The children have safe and comfortable accommodations. There is a current roster of children in the home. Children’s file have records/forms complete. Fire and disaster drills last conducted on 9/24/15. CPR/First Aid certificates are current for the Licensee and Husband with an expiration date of 02/04/2017.

This facility currently does not provides Incidental Medical Services (IMS). LPA reviewed storage of medication and Children’s Plan of Operation for providing IMS.


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.
SUPERVISOR'S NAME: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Ana TolentinoTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2016
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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