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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216076
Report Date: 03/27/2023
Date Signed: 03/27/2023 12:52:15 PM

Document Has Been Signed on 03/27/2023 12:52 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:MURGUIA FAMILY CHILD CAREFACILITY NUMBER:
406216076
ADMINISTRATOR:JOSE MURGUIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 714-3300
CITY:NIPOMOSTATE: CAZIP CODE:
93444
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
03/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Jose MurguiaTIME COMPLETED:
01:00 PM
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On March 27, 2023 at 11:10 AM, Licensing Program Analysts, (LPAs) Gigi Reyes and Dixie Wright conducted an unannounced 1 Year Required inspection. LPAs asked pre screening questions related to COVID- 19 and licensee’s responses indicate there are no COVID 19 exposures on site. LPAs met with licensee, Jose Murguia and discussed the purpose of the inspection. There were 2 children and 2 staff present.

LPAs in the company of Licensee toured the interior and exterior of the day care. LPAs observed required licensing forms are posted in the Family Child Care Home (FCCH). LPAs observed the combination smoke and carbon monoxide detectors. The regulation fire extinguisher was purchased on 3/27/2023. Home conducts and documents fire and disaster drill every 6 months, last drill was conducted on 12/2/2022. The designated play yard is enclosed by wooden fence. LPAs observed age appropriate toys and play equipment. No bodies of water were observed on site. Licensee stated there are no guns or ammunition in the home.

LPAs reviewed facility file, Pediatric CPR and First Aid expires on 11/1/2024. Licensee and Staff renewed the Mandated Reporter Training Certificate which expires on 2/11/2025. Licensee and staff have proof of immunization on file, FCCH has current roster of children in care. Children records were reviewed and found to be complete. Infant has LIC 9227 Infant Safe Sleep Plan on file. Licensee and Assistant visually check and document napping infant every 15 minutes.

During today's inspection, no deficiency was cited.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/27/2023
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: MURGUIA FAMILY CHILD CARE
FACILITY NUMBER: 406216076
VISIT DATE: 03/27/2023
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Incidental Medical Services (IMS) policy was discussed. Licensee is not providing IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home Section 102417. 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: http://www.ada.gov/childqanda.htm.

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/process.

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. LPA 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
Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were given and explained.

Exit interview conducted and report was reviewed with the licensee, Jose Murguia
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2023
LIC809 (FAS) - (06/04)
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