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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216186
Report Date: 03/02/2023
Date Signed: 03/02/2023 01:07:38 PM

Document Has Been Signed on 03/02/2023 01:07 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:CENTENO FAMILY CHILD CAREFACILITY NUMBER:
566216186
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
03/02/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Rosalia CentenoTIME COMPLETED:
01:25 PM
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On March 2, 2023 at 11:30 AM, Licensing Program Analyst (LPA) Laura Villanueva conducted an unannounced Case-Management-Licensee initiated inspection. LPA spoke to Licensee, Rosalia Centeno and conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA discussed the nature and purpose of the inspection. Licensee and LPA toured the facility inside and outside. Licensee was caring for 3 children at the time of the inspection. Licensee will be increasing her small child care license to a large child care license. LPA reviewed capacity requirements for a large child care license.

The home is a 3 bedroom, 2 bath, single story home. Licensee uses the living room, kitchen, one bathroom, and backyard for the child care. The garage and three bedrooms will not be utilized and will be designated off limits for childcare. LPA observed a screened fireplace in the living room inaccessible to children. There are age appropriate toys, teaching materials, and furnishings in good condition and free of hazards. LPA did not observe any toxins/hazardous items accessible to children. The backyard is fully enclosed with a fenced wall. Licensee has age appropriate toys in the patio readily accessible to children. Cleaning agents, disinfectants are stored in the locked garage. Kitchen knives are stored out of reach. The bathroom to be used for children in care was observed to be clean and sanitary. Fire clearance granted on 2/24/23.

Licensee's Pediatric First Aid/CPR certificate is valid until 2/10/25. Licensee's Mandated Reported Training is valid until 6/14/23. A regulation 2A10BC fire extinguisher was observed with a service date of 10/14/22. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA observed a smoke and carbon monoxide detector in the living room. LPA observed the home to be orderly. No bodies of water were observed on site. Licensee stated that there are no guns or ammunition in the home. A small dog was observed in the backyard in a gated area keeping him away from the children in care. Regulations for Family Child Care Home can be accessed on-line at www.ccld.ca.gov.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual -

Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/02/2023
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: CENTENO FAMILY CHILD CARE
FACILITY NUMBER: 566216186
VISIT DATE: 03/02/2023
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Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.html

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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.

LPA reviewed COVID-19 guidelines/resources with Licensee (RAST Technical Assistance Visit completed). LPA also reminded applicant to continue monitoring the CCLD website for COVID-19 updates and guidance. Licensee will implement pre-screening checks, promoting prior hand washing and continuously disinfecting throughout the day.



Exit interview conducted and report was reviewed with Licensee, Rosalia Centeno. A large child care license is effective today 3/2/23.
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC809 (FAS) - (06/04)
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