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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216295
Report Date: 06/06/2023
Date Signed: 06/06/2023 02:14:37 PM

Document Has Been Signed on 06/06/2023 02:14 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:ARRIAGA FAMILY CHILD CAREFACILITY NUMBER:
566216295
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
06/06/2023
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Azaria ArriagaTIME COMPLETED:
02:30 PM
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On June 6, 2023 12:15 PM, Licensing Program Analyst (LPA) Laura Villanueva made an unannounced visit to conduct a Capacity Increase and Required - 1 Year Inspection. LPA met with licensee, Azaria Arriaga and explained the purpose of the inspection. Prior to entering the facility, LPA conducted a COVID-19 risk assessment. All answers indicated no exposure to COVID-19. LPA and Licensee toured the interior and exterior of the home. Licensee and her assistant were caring for 4 children at the time of the inspection.

The home is a 3 bedroom, 2 bath single story home. The Licensee uses the living room, kitchen, dining area, 2 bedrooms, 1 will be used for the Licensee's daughter and the other is the main playroom, 1 bathroom, and front patio for the day-care. The 1 bedroom, 1 bathroom, garage/laundry room, and backyard are off limits and are made inaccessible to children in care. There are age appropriate toys, teaching materials, and furnishings in good condition and free of hazards. The backyard will be off limits and is inaccessible to children in care. Licensee is currently remodeling the backyard and the facility sketch reflects the off limits area. LPA reminded Licensee to contact CCL once construction is completed for approval to utilize area for childcare. The front patio is fully enclosed with a fenced wall. Licensee has age appropriate toys in the front yard readily accessible to children. LPA did not observe any toxins/hazardous items accessible to children. The bathroom to be used for children in care was observed to be clean and sanitary. LPA observed two small dogs in the side yard which is gated. Applicant reported that the dog's vaccinations are up to date.

A regulation 2A10BC fire extinguisher was serviced on 03/16/2023. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA observed a dual smoke and carbon monoxide detector in the home. All adults in the home are fingerprint cleared.
Continued on 809-C
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/26/2023
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: ARRIAGA FAMILY CHILD CARE
FACILITY NUMBER: 566216295
VISIT DATE: 06/06/2023
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Licensee's Pediatric First Aid/CPR certificate is valid until 07/24/2024. AB 1207 Mandated Reporter Training certificate is valid until 02/11/2024. Licensee last completed an emergency disaster drill on 5/5/2023. All required forms including Notification of Parent's Rights are prominently posted for parent's or authorized representatives to view. A roster of children in care was observed current and complete. All children records were reviewed, and LPA observed Identification and Emergency Notification forms (LIC 700) and a copy of immunization records on file.

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.

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

Continued on LIC809C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023
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: ARRIAGA FAMILY CHILD CARE
FACILITY NUMBER: 566216295
VISIT DATE: 06/06/2023
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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.

No deficiencies cited during this visit. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Azaria Arriaga.

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2023
LIC809 (FAS) - (06/04)
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