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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215950
Report Date: 07/29/2021
Date Signed: 07/29/2021 05:55:27 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 07/29/2021 05:55 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:HUITZ FAMILY CHILD CAREFACILITY NUMBER:
426215950
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 7DATE:
07/29/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:47 PM
MET WITH:Estrella HuitzTIME COMPLETED:
06:10 PM
NARRATIVE
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On July 29, 2021 @ 1:47 PM, Licensing Program Analyst (LPA) S. Mendoza-Ceja conducted an unannounced Required 1 year inspection. LPA met with Licensee Estrella Huitz and explained the purpose of the inspection. A risk assessment for COVID-19 exposure was conducted with prior to entry into the family child care home. A tour of the center was conducted inside and outside. Upon entry to the home, LPA observed child #1 (an infant) in a baby walker. Licensee was advised that the walker is prohibited equipment. Licensee stated she just put the infant in the walker to greet LPA at the door. Licensee removed the walker from the day care area.

Licensee escorted LPA through the home. During the inspection, LPA observed Licensee Huitz and her teenage daughter to providing care to seven children of which three are infants under the age of two years. Licensee stated, one of the infants was a drop in child. Licensee Huitz was advised she was exceeding the limitations of her license. The Licensee Huitz continued to escort LPA through the home. Licensee stated the child care is conducted in the primarily in the day care room, the living room, sun room. The entire home and the day care areas were inspected. The rooms available to the children were observed to be appropriately furnished for young children. LPA did observe two play yards available. LPA observed the COVID-19 posters posted for review. The backyard was observed to be completely fenced, LPA observed a BBQ pit which had poker utensil, an unsecured small trampoline and 4 propane tanks behind an insecure fence near the locked storage unit. Licensee was advised this was inappropriate for day care children.

Licensee stated she is still conducting temperature checks in the morning. The outside play area is easily accessible through the sun room. The off-limit areas of the home are the bedrooms which have key locks. Licensee was reminded the rooms shall be made inaccessible to day care children at all times.
The required 2A10 BC fire extinguisher was purchased on 04/17/2020 and was due for service or replacement by 04/17/2021.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE: DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/29/2021
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: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950
VISIT DATE: 07/29/2021
NARRATIVE
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There is carbon monoxide detector and smoke detector which were tested and operational. LPA discussed firearms and ammunition. Licensee Huitz stated there are no guns and ammunition in the home or bodies of water on the premises. LPA did not observe any bodies of water on the premises. Licensee Huitz has current Child, Infant and Adult CPR and First Aid (expires 09/28/2021).

LPA discussed the updated Regulations in regards to infant care with Licensee, including Individual Infant Sleeping Plan (LIC9227), Sleeping Chart and provided copies for her review. Licensee's AB1207 Child Abuse Mandated Reporter Training is current (expires 08/20/2021). LPA also reviewed children's records including the child care roster.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Deficiencies are being cited based on observation, interviews conducted, and record review in accordance with the California Code of Regulations, Title 22, refer to LIC809Ds. Licensee Shall provide parents with a copy of the The Type A violations and obtain the parent's signature on the LIC9227.

An exit interview was conducted, and Plan of Corrections were reviewed and developed with the Licensee Huitz. A copy of this report and appeal rights were discussed and left with Licensee Huitz.

LPA observed the "Notice of Site Visit" posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 07/29/2021 05:55 PM - It Cannot Be Edited


Created By: Sylvia Mendoza-Ceja On 07/29/2021 at 03:14 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/29/2021
Section Cited
CCR
102417(g)(4)

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The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).
This requirement was not met and evidenced by
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Licensee shall submit a written plan to the Department for review by 07/30/2021.
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LPA's observation and interview with Licensee Huitz who placed child #1 in a walker. Licensee removed child #1 from the walker when advised the walker was prohibited equipment in licensed facilities.
This poses an immediate risk to the Health and Safety of Children in care.
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Type A
07/29/2021
Section Cited
CCR102416.5(b)(2)

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For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following:...Six children, no more than three of whom may be infants;
This requirement was not met and evidenced by
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Licensee shall submit a written plan to the Department for review by 07/30/2021.
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LPA's observation and interview with Licensee Huitz who was providing care to seven children of which three are infants under the age of two years.

This poses an immediate risk to the Health and Safety of Children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2021


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/29/2021 05:55 PM - It Cannot Be Edited


Created By: Sylvia Mendoza-Ceja On 07/29/2021 at 03:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/29/2021
Section Cited
CCR
102417(g)(4)

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The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to:...Poisons, detergents, cleaning compounds, medicines...other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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Please correct immediately,
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This requirement was not met and evidenced by
LPA's observation of a BBQ pit which had poker utensil, an unsecured small trampoline and 4 propane tanks behind an insecure fence near the locked storage unit.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2021


LIC809 (FAS) - (06/04)
Page: 4 of 6
Document Has Been Signed on 07/29/2021 05:55 PM - It Cannot Be Edited


Created By: Sylvia Mendoza-Ceja On 07/29/2021 at 04:44 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/02/2021
Section Cited
CCR
102417(g)(1)

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Operation of FCCH... The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal.


This requirement was not met as evidenced by
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Please submit verification to Licensing for review by 08/02/2021.
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LPAs inspection and interview with licensee revealed the 2 A10 BC Fire Extinguisher expired 04/17/2021 and has not been serviced or replaced.
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Type B
07/30/2021
Section Cited
CCR102425(j)(2)(d)

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Infant Safe Sleep...The provider shall supervise infants while they are sleeping and adhere to the following requirements:
...(2) The provider shall check and document the following: (A) Labored breathing. (B) Signs of distress which includes but is not limited to flushed skin color, increase in body temperature and restlessness.
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Please submit a written plan of correction to Licensing to ensure this violation is not repeated. Licensee was provided an Infant Sleep Chart at the visit.
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This requirement was not met and evidenced by review of records and interview with licensee revealed she has not documentented Infant's Sleep every 15 minutes as required. This poses a potential risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2021


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 07/29/2021 05:55 PM - It Cannot Be Edited


Created By: Sylvia Mendoza-Ceja On 07/29/2021 at 05:01 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HUITZ FAMILY CHILD CARE
FACILITY NUMBER: 426215950

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/30/2021
Section Cited
CCR
102425(c)

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Infant Safe Sleep: An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 month of age the provider has in care and maintained at the facility in the infant’s file.
(1) This plan shall be signed and dated by the infant’s authorized representative. (2)The Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be maintained in the
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Correct Immediately.

Licensee shall submit a written plan of correction to Licensing by 08/02/2021
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infant’s file and shall be available to the Department for review.
This requirement was not met and evidenced by interview with licensee and review of records which revealed child #3 did not have a LIC9227 Sleeping Plan in file. This poses a potential risk to the Health and Safety of Children in care.
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Type B
08/02/2021
Section Cited
CCR102421

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Childrens' Records
Children's files were found to be incomplete.


This requirement was not met and evidenced by
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Please submit verification to Licensing for review by 08/02/2021.
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Review of seven children's files revealed the following forms were missing from the seven files: Parent's Rights LIC995, Affidavit Regarding Liability Insurance LIC282, and Parent Notification Additional Children in Care (LIC9150). This poses a potential risk to the Health and Safety of Children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Sylvia Mendoza-Ceja
LICENSING EVALUATOR SIGNATURE:
DATE: 07/29/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/29/2021


LIC809 (FAS) - (06/04)
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