406216887-10-1-2025-17-CC-MSAN-DM2TJQ-20251001144643

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406216887
Report Date: 10/01/2025
Date Signed: 10/01/2025 02:46:59 PM

Document Has Been Signed on 10/01/2025 02:46 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:	MORENO FAMILY CHILD CARE		FACILITY NUMBER:	406216887
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 3	DATE:	10/01/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:30 PM
MET WITH:	Tamara Moreno		TIME VISIT/ INSPECTION COMPLETED:	03:15 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	On 10/1/25, at 12:30 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced annual random and capacity increase inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Tamara Moreno, Licensee of the FCCH, and explained the nature and purpose of the inspection. The LPA, in the company of Licensee, toured the interior and exterior of the FCCH. The FCCH is a 3-bedroom and 3-bathroom single story home. The FCCH utilizes a living room (converted day care room), dining room, two bedrooms (one guest bedroom is excluded), all three bathrooms, and backyard. The remainder of the home is excluded from childcare services (front yard/drive way, kitchen, garage, and one guest bedroom). Importantly to note, excluded rooms and areas are made inaccessible by child safety locks. At the time of the inspection, LPA observed 3 children present (two of whom are biological children), one of which was an infant. The Licensee's partner (both cleared and associated) was also present at the time of the inspection. LPA observed the FCCH to be orderly and clean. The bathrooms, utilized for childcare services, are clean, orderly, and free of toxins. Bathroom cabinets are made secure by child safety latches and are free of any hazardous items. Sharps and personal medication were observed in elevated and locked kitchen cabinets. No children currently require medication. Cleaning supplies are kept in a locked and elevated space in the laundry room and garage. Importantly to note, LPA also observed a gas fireplace in the living room that is enclosed by glass and is barricaded by a metal screen. Licensee also has a First Aid Kit in the residence for the day care. LPA observed age-appropriate books, toys, and other furnishings throughout the interior of the FCCH (living room and two bedrooms). LPA observed appropriate licensing forms and documents posted prominently to a bulletin board at the entryway of the FCCH. LPA observed separate smoke and carbon monoxide detectors in the (CONT. 809-C, Page 2)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: MORENO FAMILY CHILD CARE	FACILITY NUMBER: 406216887
	VISIT DATE: 10/01/2025

NARRATIVE

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FCCH. At 1:41 PM, the carbon monoxide detector was tested and at 1:44 PM the smoke detector was tested and both were found to be operational. LPA also observed a regulation fire extinguisher in the FCCH, which was last serviced on 4/25/25. LPA reminded the Licensee to service or purchase a regulation fire extinguisher annually. LPA reviewed the FCCH's fire/disaster drill log. The most recent fire drill occurred on 9/21/25. Licensee informed LPA that the FCCH conducts disaster drills every six months in accordance with Department regulations.

As aforementioned, the backyard is accessible to children in care. The FCCH's outdoor area is enclosed by secure wooden fencing throughout. The fence’s entry/exit points are secure. As is the case with the interior of the FCCH, the outdoor area has age-appropriate play structures, toys, and other equipment throughout the area that can afford for robust childcare services. Licensee was reminded to replace toys and play equipment which start to degrade or are not in good repair. The footing of the exterior is made up solely of concrete pavement. Shade is provided by a large pergola and by the house itself. The Licensee attested to LPA that children are always supervised when engaged in outside activity. Licensee informed LPA that there is one body of water in the backyard of the house. LPA observed the jacuzzi to have a weighted and tight fitting cover along with straps added to it and was also free of any water. Licensee informed LPA that no pets are on site.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records, among other relevant licensing documents. The Licensee's records were also reviewed. The Licensee’s CPR/First Aid Training (EMSA approved), expiring on 11/20/26, and their Mandated Reporter Training, expiring on 9/22/26, is 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 no firearms and ammunition present within the FCCH.

The control of property was reviewed. Because the Licensee rents/leases the home, a proof of landlord notification is required. LPA observed the Property Owner/Landlord Notification Form (LIC 9151) that the Applicant confirmed was provided to the property owner/landlord. The Licensee also obtained a signed Property Owner/Landlord Consent Form (LIC 9149).

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 (CONT. 809-C, Page 3)

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025

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: MORENO FAMILY CHILD CARE	FACILITY NUMBER: 406216887
	VISIT DATE: 10/01/2025

NARRATIVE

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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 Family Child Care Homes 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 interview and record review, LPA confirmed 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, 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, 10/1/25.

During today's visit, no deficiencies were issued.

On 9/12/25, the Licensee submitted documentation for a FCCH change of capacity. The Licensee is seeking to change the FCCH’s license capacity from 8 (Small FCCH) to 14 (Large FCCH). The City of Paso Robles Fire Department granted a fire clearance following an inspection completed at the FCCH on 9/25/25.

This home meets Title 22 Division 12 requirements for a Large FCCH License. A capacity increase from 8 children (small license) to 14 children (large license) is granted on today's date, 10/1/25.

The 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, Tamara Moreno.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Matthew Sapien
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/01/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2025

LIC809 (FAS) - (06/04)

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