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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216758
Report Date: 10/30/2023
Date Signed: 10/30/2023 03:37:19 PM

Document Has Been Signed on 10/30/2023 03:37 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:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
426216758
ADMINISTRATOR:ANAHI GUZMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(779) 845-1816
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/30/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
01:40 PM
MET WITH:Anahi GuzmanTIME COMPLETED:
03:40 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 10/30/23, Licensing Program Analyst (LPA) Elvin Baddley conducted an announced Prelicense Inspection of the abovementioned home and met with Applicant Anahi Guzman. LPA informed Applicant of the nature and purpose of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Child Care Home (FCCH) from 5:00 AM--6:00 PM, Monday- Friday. Applicant also intends to care for children 0 years of age to 12 years of age. Applicant was informed changes in licensing hours and/or the ages of children supervised and cared for can be altered upon notifying CCLD of the modification and/or changes. LPA notes no children are on site at the time of the inspection.

LPA, in the company of Applicant, toured the the interior and exterior of the home in its entirety. The home is two story dwelling with three bedrooms and two and a half bathrooms. The home's living room, dining room, lower floor bathroom and backyard will be used for child care services, while the remainder of the home is excluded. LPA observed a child safety gate at the base of the stairwell.

LPA observed the home to be clean and orderly. The home has spacing and ventilation for children in care. The home has no fireplace, however there is central heating and air vents on the ceiling of the home. The bathroom to be used by children in care is observed to be clean and free of toxins. Cleaning compounds are stored in the home's garage and laundry room. Sharps and medication are observed in an elevated kitchen cabinet which are beyond the reach of children.

LPA observed a fire extinguisher (2A10BC) in the home which was purchased on 9/26/23. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has a number of combination smoke/carbon monoxide detectors. A combination smoke/carbon monoxide detector was tested at 2:00 PM and found to be operable.

The backyard area is enclosed by wooden fencing and the entry/exit gate is secured. Footing in the area is made up of a concrete slab and artificial grass. LPA observed no bodies of water on site. The home is
(CONT. 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/30/2023
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216758
VISIT DATE: 10/30/2023
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
located in a gated community with an enclosed swimming pool. LPA reminded Applicant to refraining from using the community swimming pool for day care services. Applicant is also reminded to provide direct supervision of children when children are involved in outdoor activities away from the home.

LPA's record review revealed Applicant's Mandated Reporter training was completed on 9/13/23 (expiration 9/13/25), and Pediatric CPR/First Aid (EMSA approved) was completed on 8/16/23 (expiration 8/15/25). Applicant completed Preventative Health Training on 6/1/23. LPA reminded Applicant of obligation to maintain current training and certifications. Because the Applicant rents/leases the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC 9151) that the Applicant confirms was provided to the property owner/landlord. The Applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149). Applicant does not have liability insurance. LPA provided LIcensee LIC 282 form with respect to liability insurance. Applicant informed LPA the home has no ammunition or firearm on site. There is a dog on site. LPA reviewed the vaccination records for the dog which were current.

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) or (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.

LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep, as an additional resource. LPA also informed Applicant 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 of infant devices or their purchased equipment.

Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or
(CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426216758
VISIT DATE: 10/30/2023
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
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.

On this date, 10/30/23, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility address. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Applicant was informed of the MyChildCarePlan.org site, 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.



Exit interview conducted and report was reviewed with the Applicant Anahi Guzman. The home received a fire clearance from the Santa Maria Fire Department for a capacity of 14 on 10/10/23. As such, the home meets Title 22 Division 12 requirements of a Large (14) FCCH License. Effective date of license will be noted as the present, 10/3023.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 10/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3