<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426208135
Report Date: 10/07/2022
Date Signed: 10/07/2022 03:07:16 PM

Document Has Been Signed on 10/07/2022 03:07 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:SAUCEDO FAMILY CHILD CAREFACILITY NUMBER:
426208135
ADMINISTRATOR:MARIA SAUCEDOFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 720-0160
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
10/07/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Maria SaucedoTIME COMPLETED:
03:10 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 October 7, 2022, 1:30 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Licensee, Maria Saucedo. LPA asked Covid-19 pre reening questions, licensee's responses indicate there are no COVID 19 exposure on site. Licensee provided LPA a tour of the facility inside and out. There were 5 children present during the inspection.

This is a two story home with 4 bedrooms and 3 bathrooms. Family Child Care Home (FCCH) uses living room, kitchen, dining, 2 bedrooms, the 1st bedroom is used for day care activities and the master's bedroom adjacent to the dining is used for for napping infants. LPA observed age appropriate toys, books and furnishings in the indoor activity area. The bathroom used by children was observed to be clean and free of toxins. The 2nd bedroom is not accessible to children. The second floor are off limits with baby gate at the bottom of the stair case. LPA observed a pack n play in the master bedroom which is used only for napping infants. All items are stored inaccessible to children in care. The outdoor activity area is enclosed with a brick wall. LPA observed age appropriate play equipment and toys in the backyard. Nobodies of water was observed. Licensee stated there are no guns nor ammunition in the home.

LPA reviewed the following documents, Pediatric CPR and First Aid Card expires on 5/17/2023 Licensee's immunization records are on file. Mandated Reporter Training was renewed on 6/16/2022. FCCH conducts fire and disaster drill every 6 months last drill was conducted on 8/8/2022. Children's roster is current. LPA reviewed children records, Children have emergency and identification cards on file. Infant Safe Sleep Plan (LIC9227) for Infants 0 to 12 months are completed and napping infants are checked and documented every 15 minutes.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/07/2022
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 2
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: SAUCEDO FAMILY CHILD CARE
FACILITY NUMBER: 426208135
VISIT DATE: 10/07/2022
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
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes 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.

LPA 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.

During today's inspection, no deficiency was cited.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Maria Saucedo.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC809 (FAS) - (06/04)
Page: 2 of 2