566216291-8-2-2023-17-CC-SMAZ-CUBPFL-20230802111654

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566216291
Report Date: 08/02/2023
Date Signed: 08/02/2023 11:17:00 AM

Document Has Been Signed on 08/02/2023 11:17 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	IZA FCCH AKA MY FIRST ABCS EXPERIENCE		FACILITY NUMBER:	566216291
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 1	DATE:	08/02/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Aurora Iza		TIME COMPLETED:	11:31 AM

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On August 2, 2023, Licensing Program Analyst (LPA) Susana Martinez conducted an announced pre-licensing inspection. LPA discussed the nature and purpose of the inspection. Licensee and LPA toured the facility inside and outside. Licensee stated there are no firearms or ammunition inside the home. At the time of inspection 1 child (applicants 1 year old child) and no other adults were present. Applicant's operating hours are M-F 24 hrs.

This home has four bedrooms, 3 bathrooms, living room, kitchen, dining room, converted garage, back yard that is enclosed, and a detached studio in the backyard. All tenants living on the premises have been fingerprint cleared. Licensee stated kitchen, living room, dining room, 3 bedrooms, one bathroom and backyard will be utilized for children in care.

Kitchen cabinets and drawers have safety locks. LPA observed doors to be locked and/or equipped with child safety handles preventing children from gaining access. Detergents and cleaning compounds are stored outside. Knives were observed to be kept in a locked drawer. Applicant plans on providing meals to children in care. LPA advised applicant to be cognizant of possible food allergies children may have. If food is not provided and food is brought from the children’s homes; containers shall be labeled with child’s name and properly stored or refrigerated.

There are no bodies of water present at the time of inspection. Fire and carbon monoxide alarms are located in the hallway. Fire extinguisher 3A10BC is fully charged with a purchase date of 7/1/2023. Applicant is reminded to service or purchase the fire extinguisher yearly.

Children have access to toys that are age-appropriate inside and outside of the home. During the tour, LPA did not observe any hazards/toxins items accessible to children in care. Licensee's Pediatric First Aid/CPR certificate is valid through 3/8/2024. Licensee was reminded to renew her certification every two years. Licensee was reminded a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter certification AB1207 every two years at www.mandatedreporterca.com

Continued on 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

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: IZA FCCH AKA MY FIRST ABCS EXPERIENCE	FACILITY NUMBER: 566216291
	VISIT DATE: 08/02/2023

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In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification, TB clearance, immunization's, and a valid criminal record clearance associated to the facility license. A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home. Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. Mandated reporter requirements was reviewed and explained.

Children and Staff records must be maintained and updated as needed and must be available for review by the Department.

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.

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.

Smoking is prohibited in a family child care home, 24/7.

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.

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SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

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: IZA FCCH AKA MY FIRST ABCS EXPERIENCE	FACILITY NUMBER: 566216291
	VISIT DATE: 08/02/2023

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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-and-resources/safe-sleep, as an additional resource. LPA provide PIN 20-24-CCP-SP regarding infant safe sleep. 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. The following was provided in Spanish:
LPA provided PIN 20-24-CCP: Recently Approved Safe Sleep Regulations in Effect. LPA also provided a copy of Safe Sleep FAQ's along with a Safe Sleep Brochure, Individual Infant Sleeping Plan (LIC 9227), and a Safe Sleep Sleep Log Chart. LPA reminded licensee that 15-minute checks must be conducted for all sleeping infants up to age 2 and logged on the chart. LPA also reminded licensee that only infants up to 12-months of age need to be repositioned to sleep on their backs if Section C of the LIC 9227 has not been completed and they are observed in a different sleeping position.

Applicant 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.

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.
LPA provided a pictorial ratio and capacity sheet and items not permitted in the home.

The home meets Title 22 Division 12 requirements of a Small FCCH. Effective date of license is today, August 2, 2023. Once licensed, the applicant is required to comply with the terms and limitations stated on the license. A copy of this report was reviewed and provided to the applicant.

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

Exit interview conducted in Spanish and report was reviewed with the applicant Aurora Iza.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Susana Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2023

LIC809 (FAS) - (06/04)

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