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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215967
Report Date: 06/16/2021
Date Signed: 06/16/2021 11:24:02 AM

Document Has Been Signed on 06/16/2021 11:24 AM - 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:VIEYRA FAMILY CHILD CARE AKA KIDS 'R' KIDSFACILITY NUMBER:
426215967
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 2DATE:
06/16/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Michelle VieyraTIME COMPLETED:
11:30 AM
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On 6/16/2021, at 10:00 AM Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Required Annual Inspection of the Vieyra Family Child Care Home ( FCCH) LPA met with Licensee Michelle Vieyra and discussed the purpose of the inspection. Due to COVID-19 pandemic, LPA asked the pre screening questions prior to inspection. Licensee's responses indicate there was no COVID-19 exposure on site.

LPA toured the interior and exterior of the home. LPA observed 2 children, one belong to the licensee. The home uses living room, dining area, hallway bathroom, kitchen and front yard for day care. The 3 bedrooms are not accessible to children and kept locked. The front yard is completely fenced and its surface is free of hazardous item. The bathroom is observed to be clean and free of toxin. Kitchen knives, cleaning and washing detergents are kept inaccessible to children. At 10:23 AM, carbon monoxide and smoke detectors were tested and found functional. 2A10 BC fire extinguisher was purchased on 5/2/2021. Licensee stated there are no guns or ammunition at home. LPA did not observe any bodies of water.

LPA observed required Licensing forms are posted in the wall by the living room. Licensee has current Pediatric CPR training certificate which expires on 12/19/2021, Licensee took the Mandated Reported Training per AB1207 on 6/21/2021. LPA advised Licensee that Mandated Reporter training should be renewed every two years.
Continued on 809 C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2021
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: VIEYRA FAMILY CHILD CARE AKA KIDS 'R' KIDS
FACILITY NUMBER: 426215967
VISIT DATE: 06/16/2021
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 LPA randomly reviewed children's file and found complete. FCCH has current children's roster. FCCH conducts and documents Fire and disaster Drill every month, last drill was conducted on 6/10/2021.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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: www.ada.gov/childqanda.htm

LPA reviewed and provided Licensee with the Safe Sleep Regulations and form LIC 9227 Individual Infant Safe Sleeping Plan. LPA reiterated that crib or play yards shall be free from all loose articles, and sleeping infant (0 -24 months) physical supervision and documentation every 15 minutes. LPA provided the web site address to obtain forms, review quarterly updates, review Title 22 & Health & Safety Codes is: https://www.cdss.ca.gov/inforesources/child-care-licensing.

Exit interview was conducted with Licensee .The home is in compliance of Title 22 Division 12 of California Code of Regulations and Health and Safety Code.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2021
LIC809 (FAS) - (06/04)
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