426216956-5-1-2024-17-CC-GNEE-D4UTH9-20240501144422

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216956
Report Date: 05/01/2024
Date Signed: 05/01/2024 02:44:42 PM

Document Has Been Signed on 05/01/2024 02:44 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:	LOPEZ FAMILY CHILD CARE		FACILITY NUMBER:	426216956
ADMINISTRATOR/ DIRECTOR:	LOPEZ, LETICIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 252-6240
CITY:	LOMPOC	STATE: CA	ZIP CODE:	93436
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	05/01/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:30 AM
MET WITH:	Leticia Lopez		TIME VISIT/ INSPECTION COMPLETED:	02:55 PM

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On 5/01/2024 Licensing Program Analyst (LPA) German Negrete conducted an announced pre-licensing/Change of location inspection for a Large Family Child Care Home (FCCH) license. Leticia Lopez was previously licensed at another location in Lompoc, California, License #426216201. LPA met with Leticia Lopez. The purpose of the inspection was discussed with applicant. Applicant and LPA toured the inside and outside of the home. There were zero children in care at the time of the inspection. Applicant states there are 4 adults living in the home, all adults have been fingerprint cleared but four adults are awaiting to transfer their fingerprint clearance to the new license number L#426216956.

Applicant requested to continue to operate a large family childcare license. Fire clearance was obtained. The home is a single-story home which consists of four bedrooms , two bathrooms, living room, dining room, kitchen, garage and outdoor play area that is fenced off. The areas used for day-care are as followed: living room, dining room, hallway bathroom, and outdoor play area. The off-limits areas consist of bedroom#1 & bedroom#2 ,bedroom#3, Master bedroom/bathroom, kitchen, garage. LPA observed door locks on bedroom#1, bedroom#2, bedroom#3 & Master bedroom/bathroom and garage doors making the areas inaccessible to day-care children. The Kitchen will have a steel panel configuration making the kitchen inaccessible to day-care children. Continued on LIC809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 426216956
	VISIT DATE: 05/01/2024

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The bathroom to be used for children in care was observed to be clean and free of toxins. LPA observed home has age-appropriate chairs, tables, equipment, toys and other materials for childcare activities.

LPA observed the home is clean and orderly. In addition, there is plenty of ventilation for the children in care. LPA did not observe any toxins accessible to children in care. The knives in the kitchen are secured inside a cabinet with a child safety lock making these items inaccessible to children in care. No hazardous items were observed to be accessible to children in the home. Medication is stored in a locked cabinet, elevated in the kitchen. Cleaning compounds were observed in the garage making these items inaccessible to children in care. There are no bodies of water on the property. Applicant stated no guns or ammunition is the home.

LPA observed a fire extinguisher (2A10BC) in the home which was serviced on 4/24/2024 LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually. The home has a smoke detector that was tested and observed operable on 5/1/2024 at 12:01PM. The home has a carbon monoxide detector, tested and observed operable on 5/1/2024 at 1:36PM.

LPA record review revealed Applicant is not current with immunizations required by SB792. Mandated Reporter training is currently expired. Pediatric CPR/First Aid (EMSA approved) training was completed on 6/25/2022 and expires on 06/25/2024. Applicant completed Preventative Health Training on 2/24/2018, and the CCLD Orientation on 11/18/2015 . LPA reminded Applicant of obligation to maintain current training and certifications. The Applicant submitted control of property for the home. Continued on LIC809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 426216956
	VISIT DATE: 05/01/2024

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Applicant was informed baby walkers, jumpers, bouncers, exersaucers, or any similar article are not permitted on the premises during day care hours.

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 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.

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 reviewed and provided copies to applicant of forms listed in 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. Continued on LIC809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 426216956
	VISIT DATE: 05/01/2024

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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 on their purchased equipment.

On this date, 5/1/2024, 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 addresses. 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.

Licensee 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.

Continued on LIC809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: LOPEZ FAMILY CHILD CARE	FACILITY NUMBER: 426216956
	VISIT DATE: 05/01/2024

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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 platforms. 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 does not meet Title 22 of CCR requirements for a Large Family Child Care license . Applicant will be pending managers review once the following requirement are submitted to the department.

1.Mandated Reporter Training Certificate
2.Measles vaccine
3.Pertussis vaccine
4. Finger print clearance needs to be associated to the new License 426216956.

These documents of verification need to be submitted by 06/24/2024 .
The inspection visit was conducted in Spanish and report was translated in Spanish by LPA German Negrete .LPA conducted exit interview with Leticia Lopez.

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

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

LIC809 (FAS) - (06/04)

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