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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406217123
Report Date: 10/30/2024
Date Signed: 10/30/2024 03:45:04 PM

Document Has Been Signed on 10/30/2024 03:45 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:MACIAS FAMILY CHILD CAREFACILITY NUMBER:
406217123
ADMINISTRATOR/
DIRECTOR:		MACIAS, MARILYNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 674-3779
CITY:TEMPLETONSTATE: CAZIP CODE:
93465
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/30/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:25 PM
MET WITH:Marilyn MaciasTIME VISIT/
INSPECTION COMPLETED:
04:15 PM
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On 10/30/2024, at 1:25 PM, Licensing Program Analyst (LPA) Joaquin Mendez conducted an announced Pre-licensing Inspection and met with Applicant, Marilyn Macias. LPA informed Applicant of the nature and purpose of the inspection. The applicant informed LPA of the intention to maintain operating hours of a Family Childcare Home (FCCH) from 6:30 AM to 5:30 PM, Monday- Friday. The applicant also informed LPA of the intention to provide care for children 0 months to 8 years of age. Applicant was informed changes in licensing hours and/or the ages of children supervised and cared for can be altered upon notifying CCLD in writing of the given modifications and/or changes. The applicant reports there is (1) adult that lives in the home and one (1) adult has received criminal record clearance. LPA note that at the time of inspection there was the applicant alone in the home.

LPA toured the interior and exterior of the residence with the Applicant. This is a single-story apartment home that consists of two (2) bedrooms, two (2) bathrooms, one (1) living room, one (1) dining area, and kitchen. LPA observed a playground 50ft from the front door of the home. Applicant reported day care services will occur in the (1) living room, bedroom (converted for daycare), dining area, and hallway bathroom. Meanwhile, one (1) master bedroom with bathroom, and kitchen area will be inaccessible to children in care. Additionally, LPA observed a slide lock at the top of the master bedroom door that make the bedroom area secure and inaccessible. LPA observed that the living room, dining room, (1) bedroom, and one (1) bathroom, have plenty of spacing and ventilation for the comfort of children in care.
· LPA observed sharps are stored in an elevated cabinet in the kitchen and applicant was advised to securely lock cabinet.
· Cleaning compounds are stored in a closet in the dining room and needs to be secured and locked.
· Medication for the family is stored in an elevated cabinet located in the kitchen and must be securely locked and inaccessible to children in care.
Continue on LIC809C pg2
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 4
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: MACIAS FAMILY CHILD CARE
FACILITY NUMBER: 406217123
VISIT DATE: 10/30/2024
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· The bathroom that will be used by children was observed to be clean and free of toxins.
· LPA observed items, equipment, toys, and furnishings for the children in care that are in good condition and age appropriate. LPA note, the applicant having a playpen and multiple cots to meet the infant and children’s sleeping needs.
· LPA observed a required fire extinguisher (2A10BC) in the home that was purchased on 6/21/2024. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually.
· The home has a combination smoke and carbon monoxide detector on the hallway ceiling and was tested at 1:44 PM and was operable.

LPA observed the outdoor front yard play area to be completely fenced.

· The applicant stated that children will make trips to the playground just outside the home for outdoor recreational use. LPA advised the applicant to secure permission from parents and document accordingly prior to taking children outside of the home.

· Applicant reported filtered water will be accessible by means of a water bottles, and a water jug in the home. Applicant stated they will use individual water cups for the children in care.

· LPA notes no bodies of water were observed.

· Applicant reported there are no guns and ammo in the home.

LPA’s record review revealed applicant to be complete with required documents.


· Applicant completed FCCH orientation on 6/05/23.
· Preventative Health training was complete on 10/10/2024.
· Pediatric CPR/First Aid (EMSA approved) on 6/15/24 and expires 6/15/2026.
· Applicant completed Mandated Reporter training on 6/08/2023 and expires 6/08/2025.
· LPA reminded Applicant of obligation to maintain current training and certifications.
· Applicant does not have liability insurance for the license yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282).

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and

continue on LIC809C pg3

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: MACIAS FAMILY CHILD CARE
FACILITY NUMBER: 406217123
VISIT DATE: 10/30/2024
NARRATIVE
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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.

Licensee Marilyn Macias RENTS/LEASES THE HOME AND HAS LANDLORD CONSENT:

Because the Marilyn Macias rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant Marilyn Macias confirms was provided to the property owner/landlord. The applicant obtained signed Property Owner/Landlord Consent form (LIC 9149).

APPLICANT WILL WAIT UNTIL FACILITY OPENS TO DETERMINE IMS NEEDS:

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes 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

No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

LPA reviewed with applicant Marilyn Macias, 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. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with applicant, 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. LPAs also informed applicant of the importance of checking for recalled infant devices continue on lIC809C pg4

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: MACIAS FAMILY CHILD CARE
FACILITY NUMBER: 406217123
VISIT DATE: 10/30/2024
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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, 10/30/2024, 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.

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

Applicant, 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.

The home does not meet Title 22 Division 12 requirements of a small FCCH license. Corrections must be made prior to the licensure of the home. Application is pending LPM approval.
Corrections to be made are noted as:
1. Medication and sharps must be secured in a locked cabinet inaccessible to children.
2. Closet in dining room with cleaning chemicals must be locked, secured, and inaccessible.
3. Kitchen is inaccessible and must be made so.
Applicant stated corrections would be completed by end of business day 11/10/2024.

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, Marilyn Macias.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2024
LIC809 (FAS) - (06/04)
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