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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216223
Report Date: 12/20/2024
Date Signed: 12/20/2024 02:16:43 PM

Document Has Been Signed on 12/20/2024 02:16 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:RIVERA FAMILY CHILD CARE HOMEFACILITY NUMBER:
426216223
ADMINISTRATOR/
DIRECTOR:		MARIALISA RIVERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 714-9787
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
12/20/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:57 PM
MET WITH:Marialisa RiveraTIME VISIT/
INSPECTION COMPLETED:
02:30 PM
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On December 20, 2024, at 12:57 PM, Licensing Program Analyst (LPA) Elizabeth George conducted an unannounced Annual Inspection at the above-mentioned family child care home (FCCH). LPA met with Licensee Marialisa Rivera and explained the purpose of the inspection. LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. At the time of the inspection Licensee's husband and four children were present. Licensee stated that she has not had children in care since August 2023. LPA provided the LIC9211 Request for Inactive Status.

Licensee stated that children have access to the living room, playroom, one bathroom and kitchen/dining room while the whole 2nd floor and garage are completely inaccessible to children in care. The home was orderly and clean with proper ventilation for all children in care. The bathroom used for care is clean and free of toxins. LPA observed a fireplace in the living room that is covered and made inaccessible to children. LPA observed that sharps, knives and medications are stored in the pantry which is inaccessible to children in care. LPA observed that cleaning compounds are stored in laundry room which is inaccessible to children in care. Toys, furniture and equipment in the facility are age appropriate.

LPA observed required licensing forms and documents posted by the entrance of the facility. LPA observed smoke detector/ carbon monoxide detector which was tested and found to be operational at 1:12 PM. LPA observed a regulation fire extinguisher. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the FCCH’s fire/disaster drill log, last drill was conducted on 7/13/23.

LPA observed the backyard to be completely fenced. Toys and play equipment observed in backyard are age appropriate and in good conditions. LPA observed one shed in the outdoor play area. LPA reminded licensee to keep shed locked when children are in care. LPA observed no bodies of water on site. Licensee informed LPA no firearms or ammunition are in the home. 809-C Continued on Page 2

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Elizabeth George
LICENSING EVALUATOR SIGNATURE: DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/20/2024
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 3
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: RIVERA FAMILY CHILD CARE HOME
FACILITY NUMBER: 426216223
VISIT DATE: 12/20/2024
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No Staff or children's files were reviewed as there has not been children in care for over a year. LPA reviewed Roster which confirms that last child in care was Aug 2023. LPA reviewed the Licensee’s Pediatric CPR/First Aid certifications which expire April 2025 and Mandated Reporter Training Certificate which expires February 2025. Licensee states she operates as a small licensee therefore has no additional personnel employed.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

809-C Continued on Page 3
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Elizabeth George
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
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: RIVERA FAMILY CHILD CARE HOME
FACILITY NUMBER: 426216223
VISIT DATE: 12/20/2024
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Appeals rights were provided.

Exit interview conducted and report was reviewed with the licensee, Marialisa Rivera.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Elizabeth George
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2024
LIC809 (FAS) - (06/04)
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