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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406214951
Report Date: 11/01/2023
Date Signed: 11/01/2023 01:17:30 PM

Document Has Been Signed on 11/01/2023 01:17 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GUTIERREZ FCC AKA KIDZ CAREFACILITY NUMBER:
406214951
ADMINISTRATOR:MARTHA GUTIERREZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 221-5534
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 12DATE:
11/01/2023
TYPE OF VISIT:Case Management - Annual ContinuationUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Martha GutierrezTIME COMPLETED:
01:25 PM
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On 11/1/2023, Licensing Program Analysts (LPAs) Francisca Velazquez and Elvin Baddley conducted an unannounced Annual Continuation Required Inspection of the Family Child Care Home (FCCH). LPAs met with Martha Guterriez, licensee FCCH and explained the purpose of the inspection. LPAs, in the company of licensee toured the interior and exterior of the FCCH. LPAs notes twelve (12) children were present during today’s inspection being cared by licensee and two (2) assistants Alyssa Gutierrez and Nathaniel Gutierrez.

This is a two-story home with four (4) bedrooms, three (3) bathrooms, daycare area, den, living room, dining room, kitchen, laundry room, garage, and outdoor yard. The daycare services occur in the daycare area, den, and bathroom. Meanwhile, the rest of the home is inaccessible to children in care. LPAs observed a secured gate on the first step of the stairway making the entire second floor inaccessible to children in care. Additionally, LPAs observed two (2) secured gates making the kitchen, living room, dining area and outdoor yard inaccessible to children in care. Lastly, LPAs observed the garage was locked and inaccessible to children in care.

LPAs observed the daycare areas to be orderly. There is plenty of ventilation to afford the children comfort. LPAs observed sharps are stored in an elevated cabinet in the kitchen. Cleaning compounds are stored in the laundry room and elevated cabinet in the kitchen. Medication for the family is stored in an elevated cabinet in the kitchen. LPAs notes all these areas are inaccessible to children in care. The restroom that is used for childcare services is clean and free of toxins. In the FCCH, LPAs observed toys, furniture, and equipment are in good conditions and are age appropriate for the children in care.

Required forms are predominantly posted in the daycare room wall. LPAs observed a smoke detector and carbon monoxide detector that were not tested due to children napping during this inspection. Licensee understands that both carbon monoxide and smoke detector must be operable and agrees to test both detectors when children are not sleeping. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/01/2023
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE
FACILITY NUMBER: 406214951
VISIT DATE: 11/01/2023
NARRATIVE
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The home has a regulation fire extinguisher that was serviced on 5/9/23. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services. Licensee informed LPAs there are no guns or ammo stored in the home.

Licensee reported the outdoor yard is inaccessible to children in care. LPAs observed the outdoor yard to be completely fenced. LPAs had a conversation with Licensee about ensuring all exit doors are secured. The outdoor yard provides plenty of shading for the children in care. LPAs and Licensee had a conversation about removing degrading items that could pose a danger to the children. Filtered drinking water is provided by means of individual cups. Licensee reported she has not used her outdoor and will not be using her outdoor because she will be making changes to the outdoor yard. Licensee updated outdoor sketch to reflect the outdoor yard is inaccessible to children in care. Licensee will notify the department once the outdoor yard is accessible to the children in care. No bodies of water are observed.

LPAs reviewed Licensee, assistants and children's records. The children’s records were found to be complete with emergency contact information as well as immunization records. Licensee is documenting infant 15-minute sleep logs for all children under the age of two (2) years. LPAs reviewed the facility roster that contained the names of all children present during inspection. The last emergency drill was conducted and documented on 10/6/2023. LPAs reviewed Licensee’s Pediatric First -aid certificate that expires 5/6/25 and Licensee’s Mandated Reporter training certificate expires on 6/28/25. LPAs reviewed Assistants record and found both records to be current and up to date.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Licensee was reminded that all adults 18 and over living or working in the home, 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. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE
FACILITY NUMBER: 406214951
VISIT DATE: 11/01/2023
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LPAs discussed the safe sleep regulations with licensee 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. LPAs also informed licensee 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.

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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; 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.



During the exit interview, the Licensee, Martha Gutierrez, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Martha Gutierrez.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023
LIC809 (FAS) - (06/04)
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