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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215193
Report Date: 11/05/2024
Date Signed: 11/05/2024 01:30:10 PM

Document Has Been Signed on 11/05/2024 01:30 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:SHEA FAMILY CHILD CAREFACILITY NUMBER:
566215193
ADMINISTRATOR/
DIRECTOR:
ANA VICTORIA SHEAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 300-7432
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 8DATE:
11/05/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:40 AM
MET WITH:Ana SheaTIME VISIT/
INSPECTION COMPLETED:
01:45 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 11/5/24, at 11:40 am, Licensing Program Analyst (LPA) Shane Loftus conducted an unannounced Required 3-year inspection of the Family Child Care Home (FCCH). LPA met with Licensee, Ana Shea, and explained the purpose of the inspection. LPA in the company of licensee, toured the interior and exterior of the FCCH. The FCCH uses the playroom, two bathrooms (one located in the master bedroom), living room, kitchen, two bedrooms, office, and back yard for child care. The only room that is off limits to children is the garage. Licensee, Assistant (Elizabeth Salguero), and 8 children were present at the time of inspection.

The FCCH has a regulation 2A10 BC fire extinguisher that was serviced on 4/8/24. LPA reminded licensee the fire extinguisher needs to be either serviced or newly purchased annually. The FCCH has a dual smoke alarm/carbon monoxide detector that was tested at 11:55 am and found to be functional. Cleaning supplies are in a cupboard below the kitchen sink which is secured with a child safety lock. Sharps are in a drawer in the kitchen which is off limits secured by a child safety gate. Medications are stored in the master bedroom in an elevated cupboard, which is out of the reach of children. The bathrooms were observed to be clean and orderly. The FCCH does not have a fireplace. The FCCH has ventilation for childcare services.

The outdoor area has shade for the children in care. The yard is secured by wooden fencing, entry/exit points are secured. Toys and equipment observed in the FCCH are age appropriate. There are no bodies of water on the property. There are no firearms and ammunition on the property.

The FCCH has the appropriate documentation posted. A sampling of the children's records was reviewed and found to be current including Emergency Contact Information and Immunization Records. A sampling of the staff’s records was reviewed and found to be current including CPR/First Aid training (Ana Shea completed 2/9/24 and Elizabeth Salguero completed 7/1/24) and Mandated Reporter training (Ana Shea completed 3/21/24 and Elizabeth Salguero completed 7/9/24).

Continued on 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE: DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/05/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SHEA FAMILY CHILD CARE
FACILITY NUMBER: 566215193
VISIT DATE: 11/05/2024
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
LPA reminded licensee that CPR/First Aid and Mandated Reporter AB1207 training must be updated every two years. LPA notes the last disaster and fire drill was conducted on 6/7/24. LPA reminded licensee that emergency drills are required every six months and need to be documented.

Licensee does not provide Incidental Medical Services (IMS). Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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 licensee 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 licensee 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.

Licensee was informed of the MyChildCarePlan.org website; 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.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

During the exit interview, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Continued on 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SHEA FAMILY CHILD CARE
FACILITY NUMBER: 566215193
VISIT DATE: 11/05/2024
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
To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee Ana Shea.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Shane Loftus
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2024
LIC809 (FAS) - (06/04)
Page: 3 of 3