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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426217151
Report Date: 10/31/2024
Date Signed: 10/31/2024 11:38:22 AM

Document Has Been Signed on 10/31/2024 11:38 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:GIJON FAMILY CHILD CAREFACILITY NUMBER:
426217151
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
10/31/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Heliodora GijonTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
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On 10/31/2024, at 9:05 PM, Licensing Program Analyst (LPA) Joaquin Mendez conducted an announced Pre-licensing Inspection and met with Applicant, Heliodora Gijon. LPA informed Applicant of the nature and purpose of the inspection. The applicant informed the LPA of the intention to maintain operating hours of a Family Childcare Home (FCCH) from 5:00 AM to 6:00 PM, Monday- Saturday. The applicant also informed LPA of the intention to provide care for children 0 months to 13 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 in writing of the given modifications and/or changes. The applicant reports there is four (4) adults that live in the home and four (4) adults has received criminal record clearance. LPA notes that at the time of inspection there was the applicant alone in the home.

LPA toured the interior and exterior of the residence with the Applicant. This is a single-story home, the home consists of three (3) bedrooms, one (1) bathroom, one (1) living room area (furnished into daycare room), kitchen, dining room, garage (partially converted in master bedroom), and back outdoor patio. Applicant reported day care services will occur in the living room (furnished into daycare), kitchen, dining room, one (1) hallway bathroom, and outdoor back patio with yard. Meanwhile, the three (3) bedrooms and garage will be inaccessible to children in care. Additionally, LPA observed safety doorknob covers on the bedroom doors making them inaccessible to children in care. A lock on the garage door in the kitchen secures the garage/master bedroom and inaccessible.

LPA observed that the living room (furnished into daycare) and one (1) bathroom, to have plenty of spacing and ventilation for the comfort of children in care.
· The bathroom was clean and orderly. LPA notes there are no toxins and dangerous items in the bathroom accessible to children in care.
Continue on lIC809C pg2
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE: DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/31/2024
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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151
VISIT DATE: 10/31/2024
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· Extra dish soap and cleaning supplies are stored in the washroom closet in the hallway.
· The home has a carbon monoxide and smoke combination detectors on the wall in the hallway and were tested at 9:24 AM and were found operable.

· LPA notes, the applicant does have multiple sleep cots and a crib to meet the children’s sleeping needs.

· LPA reminded the Applicant of the importance of monitoring infants and keeping up with the infant safe sleep plan and log.

· Applicant’s medication and extra cleaning supplies (Bleach, dish soap, detergents, etc.) are in the garage/bedroom on a dresser. The Garage is locked and inaccessible to children in care.

· LPA observed toys and furniture 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 and confirmed by the applicant the kitchen to be accessible to children in care.


· Knives are stored in a locked elevated cabinet in the kitchen.
· Dish soap and cleaning supplies are in a locked cabinet under the sink in the kitchen.
· LPA observed a required fire extinguisher (2A10BC) in the in the dining room wall with a purchase date of 9/07/2024. LPA reminded Applicant of the responsibility to service or purchase a regulation fire extinguisher annually.
· LPA observed safety knob covers on the stove turn knobs for the safety of children.

LPA observed the back yard patio area to be completely fenced.
· LPA observed a storage unit in the back patio which stored various garden supplies, locked with a padlock making it inaccessible to children in care. The applicant reported that children will have access to the outdoor back patio area.
· LPA did not observe any items, equipment, toys, or furnishings for children. Applicant stated once licensed applicant would purchase toys to needed for children in care and age appropriate. LPA advised the Applicant to check daily for insects and animals which may pose a threat to children in care prior to children having access to play structures and toys.
Continue on LIC809C pg3
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151
VISIT DATE: 10/31/2024
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· LPA observed two (2) separated areas in the back yard making them inaccessible. In the two (2) secured areas are bikes, yard tools and a BBQ pit in one. In the other fenced area was a lemon tree.
· Applicant reported drinking water will be accessible by means of filtered water jug in the home and a filtered water portable unit to use throughout the day. Applicant stated they will use individual water cups for the children in care.
· LPA notes no bodies of water were observed.
· Applicant reported there are no guns and ammo in the home.

LPA record review revealed all documents as noted below.
· Applicant completed FCCH orientation on 5/29/2024.

· Preventative Health training was complete on 6/28/2024.


· Pediatric CPR/First Aid (EMSA approved) and expires 5/28/2026.
· Applicant completed Mandated Reporter training and will expire 5/23/2026.
· LPA observed immunization records for all adults residing in the home. LPA reminded Applicant of obligation to maintain current training and certifications.
· Applicant does not have liability insurance for the license yet. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282).

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.

Because the applicant Heliodora Gijon 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).

Continue on LIC809C pg4

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC809 (FAS) - (06/04)
Page: 3 of 5
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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151
VISIT DATE: 10/31/2024
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APPLICANT Heliodora Gijon stated she will not provide Incidental Medical Services (IMS). 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/. http://www.ada.gov/childqanda.htm

No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

LPA reviewed with applicant Heliodora Gijon, 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: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/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, 10/14/2024, 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; 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
continue on LIC809C pg5
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: GIJON FAMILY CHILD CARE
FACILITY NUMBER: 426217151
VISIT DATE: 10/31/2024
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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

Applicant, 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.

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 Heliodora Gijon, 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, Heliodora Gijon in the applicant’s preferred language, Spanish.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Joaquin Mendez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024
LIC809 (FAS) - (06/04)
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