406214951-2-4-2025-17-CC-JMEZ-DDKSXQ-20250204131619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406214951
Report Date: 02/04/2025
Date Signed: 02/04/2025 01:16:31 PM

Document Has Been Signed on 02/04/2025 01:16 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	GUTIERREZ FCC AKA KIDZ CARE		FACILITY NUMBER:	406214951
ADMINISTRATOR/ DIRECTOR:	MARTHA GUTIERREZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 221-5534
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 6	DATE:	02/04/2025
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:10 AM
MET WITH:	Martha Gutierrez		TIME VISIT/ INSPECTION COMPLETED:	01:30 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	This is a required inspection per CDSS no. 6421215101-B Decision and Order. On 2/04/2025, at 10:07 AM, Licensing Program Analyst (LPA) Joaquin Mendez conducted an unannounced Annual Random/Comprehensive inspection of the abovementioned Family Childcare Home (FCCH). LPA met with Assistants, Alyssa Gutierrez (A1) and Marlene Perez (A2), and discussed the purpose of the inspection. Licensee, Martha Gutierrez came 30 minutes later (10:40AM) who was out to run some errands. LPA met Martha Gutierrez, Licensee of the FCCH and explained the nature and purpose of the inspection. LPA reminded the licensee that the licensee must be in the home for 80% of operational hours. LPA notes that upon entering the home were A1 and A2 with six (6) children in care. LPA viewed posted documents/forms and notes that required documents/forms are posted on the wall near the entry of the FCCH. LPA observed the Decision and Order CDSS No. 6421215101-B, which is located at the upper portion of the parent bulletin board, predominantly visible to parents during drop-off and pick-up. The LPA, in the company of Licensee, toured the interior and exterior of the FCCH. The FCCH is a four-bedroom, four (4) bathrooms, two story dwelling. FCCH day care areas are the open space by the main entrance door and napping room across the hallway while the remainder of the home is excluded from care. The FCCH was observed to be clean and orderly. LPA observed access to a laundry room and garage across from across the daycare bathroom. LPA advised the licensee to secure laundry room from any accidental access to children in care. LPA toured the laundry room and did not observe any toxic or hazardous items accessible to children. Garage door is accessible but is locked and made inaccessible to children on care. LPA reminded the licensee to always ensure the inaccessibility to inaccessible areas of the FCCH. · LPA observed a child safety gate at the base of the stairwell serving as a barricade to the FCCH’s upper story. · A metal fence is also observed at the entry of the FCCH’s kitchen/ Dining room. Continue on LIC809C pg2

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE	FACILITY NUMBER: 406214951
	VISIT DATE: 02/04/2025

NARRATIVE

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· Required forms are predominantly posted on the wall near the entry of the FCCH.
· The FCCH’s living room has a fireplace which is screened by glass.
· The FCCH's bathroom used for childcare services is observed to be clean and free of toxins.
· LPA observed and tested the smoke and carbon monoxide detectors throughout the FCCH. Both the smoke and carbon monoxide detectors were tested at 12:08PM and found to be operable.
· The FCCH has a regulation fire extinguisher on site which was service on 5/15/24. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually.
· The FCCH maintains working cell phone services.
· Medication in the home is in the upper cabinet in the kitchen which is excluded from daycare area.
· Cleaning compounds are stored in a secured laundry room in an elevated cabinet which is inaccessible to children in care.
· Sharps are observed in the kitchen which is inaccessible to children in care.
· Toys, furniture, and equipment in the FCCH are age appropriate. LPA reminded the licensee to make daily checks to play structures prior to use for the safety of children.

The backyard is also used for daycare services. However, due to weather conditions the backyard is off limits to day care. LPA with the company of the licensee toured the outside area of the backyard.

· Toys and furnishings providing activities were age appropriate for the children in care.
· LPA reminded the licensee to make daily checks of outside toys and structures prior to allowing children access.
· LPA observed a trampoline in the backyard. The Licensee stated the trampoline belongs to the licensee’s children and is inaccessible to children in care. During the inspection the LPA observed the ladder to the trampoline was missing and the entrance locked preventing access. LPA advised the licensee to secure a gate to further prevent any access to children in care.
· Licensee stated they have a family pet which is kept in a cage when daycare is operational and caged before children are allowed to play outside.

LPA conducted a records review of children enrolled in the FCCH, along with all staff members. All records are current and completed.
Continue on LIC809C pg3

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE	FACILITY NUMBER: 406214951
	VISIT DATE: 02/04/2025

NARRATIVE

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· LPA reminded Licensee to ensure Acknowledgment of Licensing Report forms (LIC 9224) should be completed for all children in care, as well as newly enrolled children in the FCCH. Further, LPA informed Licensee to ensure parents of children in care are provided one LIC 9224 for each proceeding event/report.
· CPR certification expires 5/16/2025.
· Mandated reporter certificate expires 6/28/2025. LPA reminded licensee to complete Mandated Reporter Training and CPR every (2) two years.
· Licensee has statement with refusal to take flu vaccine.
· Fire/earthquake drill last conducted 1/16/2025 with 8 children present.

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.

LPA 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. LPA also informed licensee [or facility representative] 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.

The Licensee Martha Gutierrez is not providing Incidental Medical Services (IMS). IMS policy was discussed.
Continue on LIC809C pg4

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: GUTIERREZ FCC AKA KIDZ CARE	FACILITY NUMBER: 406214951
	VISIT DATE: 02/04/2025

NARRATIVE

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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 Martha Gutierrez 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 LPA completed the RSO profile in FAS on 2/03/2024.

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

No deficiencies were cited during today's inspection.

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.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2025

LIC809 (FAS) - (06/04)

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