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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216949
Report Date: 10/02/2024
Date Signed: 10/02/2024 03:30:15 PM

Document Has Been Signed on 10/02/2024 03:30 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:HINOJOSA FAMILY CHILD CAREFACILITY NUMBER:
426216949
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: DATE:
10/02/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:54 PM
MET WITH:Ariana C. HinojosaTIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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On 10/02/24, at 12:56 P.M., Licensing Program Analyst (LPA) Joaquin Mendez conducted an announced Pre-license Inspection of the above-mentioned residence and met with Applicant, Ariana C. Hinojosa. LPA informed Applicant of the nature and purpose of the inspection. Applicant informed LPA of the intention to maintain operating hours of a Family Childcare Home (FCCH) from 6:00 AM-5:00 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 given modifications and/or changes. LPA notes no children are on site at the time of the inspection. There are 2 adults residing in the home and both adults are cleared through The Guardian website.

LPA, in the company of Applicant, toured the interior and exterior of the residence in its entirety. The residence has three (3) bedrooms, two (2) bathrooms, living room (furnished into daycare), kitchen, dining room, garage, and back yard. The areas to be used for childcare within the residence is the living room (furnished into day-care), hallway restroom, and backyard. While the remainder of the home (garage, kitchen, dining room, master bedroom with bathroom and two (2) bedrooms) is excluded from care (see LIC812).
· LPA observed locks and doorknob covers on all bedroom doors, making these rooms inaccessible to children in care.
· LPA observed a gate in the hallway preventing access to the back hallway where the bedrooms are located.
· LPA observed a regulation fire extinguisher (2A10BC) in the area for childcare which was purchased on 9/23/2024 (expiration 9/23/25). LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/02/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: HINOJOSA FAMILY CHILD CARE
FACILITY NUMBER: 426216949
VISIT DATE: 10/02/2024
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· A combination smoke/carbon monoxide detector in the living room was tested at 1:17 P.M. and found to be operable.
· The hall had one (1) closet with various blankets and supplies and was locked at the time of inspection making it inaccessible.
· LPA observed the residence to be clean and orderly.
· The residence has spaced and ventilation for children in care.
· The restroom to be used for children in care is observed to be clean and free of toxins.
· Sharps are in elevated locked cabinet in the kitchen making them inaccessible to children in care.
· Medications are in an elevated locked cabinet in the kitchen inaccessible to children in care.
· Kitchen had a retractable safety gate preventing access to children in care.
· Drinking water will be supplied by individual water bottles and individual cups for children in care.

The back yard will be used by FCCH.
· LPA observed the back yard to have shaded covering and is enclosed by wooden fencing with an emergency exit gate if needed. The footing in the area is concrete and grass with (2) two small trees in the far back of the yard.
· In the Back yard are various toys and equipment for the enjoyment of small children. Additionally, LPA reminded Applicant to replace play equipment and toys when such items began to degrade or are not in good repair.
· LPA observed a shed in the back yard and is secured and locked during inspection. In the shed are various tools belonging to the spouse for the yard.
· LPA observed no bodies of water in the back yard.

LPA reminded the Applicant to ensure direct supervision of children in care when traveling beyond the property for outdoor activities.

LPA's record review revealed Applicant's documents noted below.
· Mandated Reporter training was completed on 3/26/2024 (expiration 3/26/2026)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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: HINOJOSA FAMILY CHILD CARE
FACILITY NUMBER: 426216949
VISIT DATE: 10/02/2024
NARRATIVE
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· Pediatric CPR/First Aid (EMSA approved) was completed on 9/30/2023 (expiration 9/30/2025).
· Applicant completed Preventative Health Training on 11/17/2023.
· CCLD orientation certification on was obtained on 8/31/2022.
· LPA reminded Applicant of obligation to maintain current training and certifications.

Applicant Ariana C. Hinojosa 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 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.

Because the applicant, rents the home, proof of landlord notification is required. The LPA observed the Property Owner/Landlord Notification form (LIC9151) that the applicant confirms was provided to the property owner/landlord. The applicant obtained a signed Property Owner/Landlord Consent form (LIC 9149).

Applicant Ariana C. Hinojosa states she will wait for facility to open to decide on the needs for offer Incidental Medical Services (IMS). Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 2202-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 (TW} and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm

LPA reviewed with Applicant the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant.

LPA discussed the safe sleep regulations with Applicant and discussed the Child Care Licensing Safe Sleep webpage at:
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
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: HINOJOSA FAMILY CHILD CARE
FACILITY NUMBER: 426216949
VISIT DATE: 10/02/2024
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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.

On this date, 10/02/24, 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.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

The home meets Title 22 Division 12 requirements of a small FCCH license. License is pending LPM approval.

A notice of site visit was given to applicant Ariana C. Hinojosa, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the Applicant Ariana C. Hinojosa in the applicant’s preferred language, Spanish.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2024
LIC809 (FAS) - (06/04)
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