406216887-3-7-2024-17-CC-GRES-D35SVG-20240307131244

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406216887
Report Date: 03/07/2024
Date Signed: 03/07/2024 01:13:08 PM

Document Has Been Signed on 03/07/2024 01:13 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:	MORENO FAMILY CHILD CARE		FACILITY NUMBER:	406216887
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	03/07/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Tamara Moreno		TIME COMPLETED:	01:15 PM

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This is a change of location; the prior Facility no. was 406216310.

On March 7, 2024, at 10:50 AM Licensing Program Analyst (LPAs) Gigi Reyes conducted an announced pre-licensing inspection at the above home. LPA met with the applicant, Tamara Moreno and discussed the purpose of the inspection. Applicant’s minor child was also present.

LPA and applicant toured the interior and exterior of the home, which is a one-story structure consisting of 3 bedrooms, 3 baths, living room, kitchen, completely fenced backyard, and garage. Areas accessible to children will be the living room, 2 bedrooms, 3 bathrooms, kitchen, and the fenced backyard. Inaccessible areas are 1 bedroom and garage. There were cots, playpen age-appropriate toys, books, and equipment for children.

It was noted that knives and cleaning materials are kept inaccessible to children in care. The bathrooms for children’s use are free of toxins during the time of the inspection, cabinets have child safety locks. The 2A10 BC fire extinguisher was serviced on 3/16/2023. Carbon monoxide and smoke detectors were tested and found to be functional. LPA observed a covered hot tub but it has no lock. The applicant stated that there are no guns and ammunition in the home.

Continued LIC 809 C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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: MORENO FAMILY CHILD CARE	FACILITY NUMBER: 406216887
	VISIT DATE: 03/07/2024

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Applicant completed the Family Child Care orientation on 3/10/2022. Preventative Health and Safety Training was completed on 4/21/2022. Pediatric 1st Aid/CPR certificate expires on 5/18/2024, while the Mandated Reporter Training expires 3/9/2024 Applicant was reminded that AB 1207 and Pediatric CPR should be renewed every 2 years. The applicants stated FCCH does not have liability insurance at this time.

LPA discussed the requirement for care providers/employees, including volunteers, to obtain immunization against Influenza, Pertussis, Measles, including verification of TB, with applicant's verification being on file.

Prohibited items and equipment in the FCCH, such as walkers, bouncers, etc., were also reviewed with the applicant, as well as the LIC 311D Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Children's record-keeping requirements were also reviewed.

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) 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.

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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: MORENO FAMILY CHILD CARE	FACILITY NUMBER: 406216887
	VISIT DATE: 03/07/2024

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LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep webpage at: htttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep, as an additional resource. LPA also informed applicant 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.

On this date, 3/7/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

The applicant has not provided proof of control of property.
Because the applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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: MORENO FAMILY CHILD CARE	FACILITY NUMBER: 406216887
	VISIT DATE: 03/07/2024

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Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https:// www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

A notice of site visit was given to applicant, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the applicant, Tamara Moreno.

The issuance of small Family Child Care Home is pending approval upon completion of the following:

- Submission of Rental Agreement
- Photos of secured/locked hot tub cover

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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