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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216588
Report Date: 05/04/2023
Date Signed: 05/04/2023 11:57:23 AM

Document Has Been Signed on 05/04/2023 11:57 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:AYALA FAMILY CHILD CARE HOMEFACILITY NUMBER:
426216588
ADMINISTRATOR:JULIE AYALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 737-3040
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
05/04/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Julie AyalaTIME COMPLETED:
12:10 PM
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This is a change of location, previous facility number 426214052.

On 05/04/2023 at 10:30 AM, Licensing Program Analyst (LPA) Francisca Velazquez conducted an announced change of location, Pre-licensing inspection for a Large Family Child Care Home (FCCH) license. LPA met with Julie Ayala, applicant of the FCCH and discussed the purpose of today’s visit. LPA and Applicant together toured the inside and outside of the home. There were no children in care at the time of the inspection. There will be four (4) adults living in the home. All four (4) adults are fingerprint cleared.

Applicant requested a change of location for a large family childcare license. The home is a single-story home with three (3) bedrooms, two (2) bathrooms, one (1) daycare room, living room, kitchen, dining area, garage and outdoor patio. LPA notes that the day care services will occur in one (1) daycare room, living room, dining area, kitchen, one (1) bathroom, and outdoor patio. Meanwhile, the three (3) bedrooms, one (1) bathroom and garage will be off-limits to children in care. LPA notes, a small baby gate is located on the hallway of the FCCH making the three (3) bedrooms inaccessible to children in care. In addition, LPA observed the garage has two locks making it inaccessible to children in care.

LPA observed the daycare room is fully equipped to meet the needs of children in care. LPA observed that the FCCH is clean and orderly. In addition, there is plenty of ventilation for the children in care. LPA observed a fireplace in the living room that is made inaccessible by large pieces of furniture. LPA did not observe any toxins nor hazards items accessible to children in care. LPA observed that knives are stored on top of the refrigerator in the kitchen that is inaccessible to children in care. Detergents and cleaning compounds were observed under the sink of the kitchen that has a safety lock, in an elevated cabinet in the hallway of the FCCH that is also locked and in the garage that is also inaccessible to children in care. Medication in the home is stored in a locked elevated cabinet in the kitchen of the FCCH. The bathroom to be used for children in care was observed to be clean and free of toxins. LPA observed child size furniture and material for activities throughout the home in areas that will be accessible to children in care. CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2023
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: AYALA FAMILY CHILD CARE HOME
FACILITY NUMBER: 426216588
VISIT DATE: 05/04/2023
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LPA and applicant toured the outdoor patio. LPA observed the exits to be secured. LPA observed there is plenty of shading to afford the children in care. In addition, applicant has added mesh to add more shading for children in care. Filtered water will be accessible by means of water dispenser with disposable water cups. The back yard has age-appropriate toys and day-care equipment.

LPA observed a regulation 2A10BC fire extinguisher in the FCCH at the time of the inspection that was purchased on 05/04/2023. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed licensee test both smoke and carbon monoxide detectors in the home at 11:00 AM and were functioning at the time of the inspection.



No bodies of water were observed. Applicant stated that there are no weapons or ammunition in the home. Applicant stated she does not hold a foster family license. Applicant is current with immunization required per SB 792.

Applicant Pediatric First Aid/CPR certificate is valid until 1/22/2025. Applicant’s Mandated Reporter Training certificate is valid until 07/29/2023. Control of property was verified via receipt of rental agreement. Applicant received fire clearance from Lompoc Fire Department on 04/24/2023.

LPA discussed Incidental Medical Services with the licensee. 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: htttp://www.ada.gov/childqanda.htm

LPA reviewed and provided the handout "A Child Care Provider's Guide to Safe Sleep" (PIN 20-24-CCP), Effects of Lead Exposure, What is Carbon Monoxide, and Self- Assessment. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided online at www.ccld.ca.gov.

This home meets Title 22 Division 12 requirements of a Large FCCH license. Effective date of license will be noted as the present, 05/04/2023.



No deficiencies cited during this visit. 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: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
LIC809 (FAS) - (06/04)
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