406216433-3-7-2025-17-CC-MSAN-DEJV2R-20250307150334

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406216433
Report Date: 03/07/2025
Date Signed: 03/07/2025 03:03:50 PM

Document Has Been Signed on 03/07/2025 03:03 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:	AVALOS FAMILY CHILD CARE		FACILITY NUMBER:	406216433
ADMINISTRATOR/ DIRECTOR:	RICARDA AVALOS CALDERON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 536-0296
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 5	DATE:	03/07/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:05 PM
MET WITH:	Ricarda Avalos		TIME VISIT/ INSPECTION COMPLETED:	03:30 PM

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On 3/7/25, at 1:05 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced random inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Ricarda Avalos, Licensee of the FCCH, and explained the nature and purpose of the inspection. The LPA, in the company of Licensee, toured the interior of the FCCH. The FCCH is a 3-bedroom and 2 bathroom single story residence. The FCCH utilizes a living room (converted day care room) and a hallway bathroom. The remainder of the home is excluded from childcare services (3 bedrooms, kitchen, dining room, front yard, backyard, and garage). Importantly to note, excluded rooms and cabinets are made inaccessible via numerous child safety locks and knobs. At the time of the inspection, 5 day care children were present, one of the Licensee's children, and one staff assistant (cleared and associated).

LPA observed the FCCH to be orderly and clean. Sharps are stored in an elevated kitchen cabinet. Cleaning supplies are stored in the garage. The kitchen cabinets, like the bedrooms in the house, are made inaccessible via child safety latches and locks. No medication is currently being used by children, but personal medication is stored in the each of the guestrooms for individuals. The Licensee also possesses a First Aid Kit for the FCCH.

LPA observed age-appropriate books, toys, and other furnishings throughout the interior of the FCCH (day care room).

LPA observed appropriate licensing forms and documents posted prominently to a bulletin board in the entryway of the FCCH. LPA observed a smoke and carbon monoxide detector in the FCCH. At 1:11 PM, the carbon monoxide detector was tested, while at 1:14 PM, the smoke detector was tested. Each detector was tested and found to be operational.

LPA also observed a regulation fire extinguisher in the FCCH, which was last purchased on 3/7/25. LPA reminded the Licensee to service or purchase a regulation fire extinguisher annually. LPA reviewed the

(CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025

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: AVALOS FAMILY CHILD CARE	FACILITY NUMBER: 406216433
	VISIT DATE: 03/07/2025

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FCCH's fire/disaster drill log. The most recent fire drill occurred on 12/15/24. LPA reminded the Licensee that disaster drills are required every six months.

As previously stated, the outdoor areas of the FCCH are not accessible for day care children (front yard and backyard).

LPA reviewed children's records and they were current and complete. The Licensee's records were also reviewed. The Licensee’s CPR/First Aid Training (EMSA approved), expiring on 8/24/26, and Mandated Reporter Training, expiring on 2/7/26, are current and complete as are other relevant licensing documents and forms. Licensee was reminded to renew certifications and training prior to expirations. The Licensee informed LPA that there are firearms present within the FCCH. The firearms were observed in a large and locked safe in one of the guest bedrooms of the FCCH. Again, this room, like the others, is made inaccessible by a child safety knob. LPA did not observe any bodies of water on site.

The Licensee does not currently provide Incidental Medical Services (IMS) or administer medication to children in care. IMS policy was discussed. For IMS information see PIN 22-02CCP. 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 discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage as an additional resource at:https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep. Through record review, LPA checked that the Licensee checks and documents napping infants every 15 minutes.

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 in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, (CONT. 809-C, Page 3)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025

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: AVALOS FAMILY CHILD CARE	FACILITY NUMBER: 406216433
	VISIT DATE: 03/07/2025

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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.

During the exit interview, the LPA confirmed that there are no Registered Sex Offenders living in the facility when the LPA completed an RSO profile in FAS on today’s date, 3/7/25.

During today's visit, no deficiencies were issued. Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and the report was reviewed with the Licensee, Ricarda Avalos.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2025

LIC809 (FAS) - (06/04)

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