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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216386
Report Date: 08/29/2022
Date Signed: 08/29/2022 11:09:28 AM

Document Has Been Signed on 08/29/2022 11:09 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:GARCIA FAMILY CHILD CAREFACILITY NUMBER:
566216386
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 0DATE:
08/29/2022
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Sharon Garcia TIME COMPLETED:
11:34 AM
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On 8/29/2022 at 9:35 AM Licensing Program Analyst (LPA) Rona Chavez conducted an announced inspection for the purpose of completing a pre-licensing inspection. LPA met with Applicant Sharon Garcia and explained the nature and the purpose of the inspection. Applicant provided LPA a tour of the home inside and out. The home is a single story duplex with 2 bedrooms and 1 bathroom. All adults in the home are fingerprint cleared. The applicant will be using the living room, bathroom, kitchen and back yard for the day-care. All bedrooms and garage are off limits and will remain locked.

LPA did not observe any toxins/hazardous items accessible to children. A regulation 2A10BC fire extinguisher purchased on 7/17/2022 and was observed in the living room. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed the home has functioning smoke and carbon monoxide detectors. LPA observed a wall heater in the living room with a cover and a gate to prevent children from having access. There were age appropriate toys and furniture in the home. LPA observed the home to be orderly. Applicant stated they do not have firearms or ammunition in the home. No bodies of water were observed on site. Detergents and cleaning compounds are stored out of reach of children. The bathroom to be used for children in care was observed to be clean and sanitary. The back yard has age appropriate toys a sink and drinking water available.

Preventative Health & Safety and Nutrition Training completed on 8/13/22. Applicant First Aid/CPR certificates is valid until 7/09/2024. Applicant AB 1207 Mandated Reporter Training Certificate completed on 7/13/2022. Applicant provided control of property. LPA discussed and verify SB 792 (Child Care Employee and Volunteer: Immunization and Tuberculosis Requirements). Applicant was informed walkers, bouncers and any similar object that restricts children's movement is prohibited from licensed facilities.



Continued on 809-C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2022
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: GARCIA FAMILY CHILD CARE
FACILITY NUMBER: 566216386
VISIT DATE: 08/29/2022
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LPA reviewed, discussed and gave applicant updated samples of state required forms to be kept in the children's file, required forms to be posted and forms that needs to be maintained at the Family Child Care Home (FCCH). LPA discussed information about Sudden Infant Death Syndrome, Never Shake a Baby, and Capacity requirements. A guide to Effects of lead poisoning and Safe Sleep information was provided to applicant. Applicant was made aware that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.cdss.ca.gov. LPA went over all safe sleep regulations.

LPAs reviewed COVID-19 guidelines/resources with applicant. LPA also reminded applicant to continue monitoring the CCLD website for COVID- 19 updates and guidance.

License to operate a Family Child Care facility is effective today 8/29/2022.

A copy of this report was reviewed and provided to the applicant. Notice of Site visit posted (LIC9213).

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Rona Chavez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022
LIC809 (FAS) - (06/04)
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