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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216566
Report Date: 05/03/2024
Date Signed: 05/03/2024 12:57:25 PM

Document Has Been Signed on 05/03/2024 12:57 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:SALINAS FCCHFACILITY NUMBER:
566216566
ADMINISTRATOR/
DIRECTOR:
FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
05/03/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Leticia SalinasTIME VISIT/
INSPECTION COMPLETED:
01:30 PM
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On May 3, 2024 at 11:20 AM, Licensing Program Analyst (LPA) Laura Villanueva made an unannounced visit to conduct a Case Management-Licensee Initiated Inspection. LPA met with licensee, Leticia Salinas and explained the purpose of the inspection. LPA and licensee toured the interior and exterior of the home. Licensee was caring for 3 children at the time of the inspection.

The home is a 5 bedroom, 3 bath, 2 story home. Licensee uses the kitchen, dining area, family room, one bathroom, and backyard for the child care. All bedrooms, 2-bathrooms, and garage will not be utilized and will be designated off limits for childcare. LPA observed a screened fireplace in the living room inaccessible to children. LPA did not observe any toxins/hazardous items accessible to children. The backyard is fully enclosed with a fenced wall. Cleaning agents and disinfectants are stored in a 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. The stairs to the second floor was gated and inaccessible to children.

A regulation 2A:10BC fire extinguisher was in the kitchen with a service date of 03/25/2024. Licensee is reminded to service or purchase the fire extinguisher yearly. LPA observed smoke and carbon monoxide detectors in the hallway. Licensee has a total of 6 smoke detectors throughout the home. All adults in the home are fingerprint cleared. 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.

Licensee's Pediatric First Aid/CPR certificate is valid until 12/07/2024 AB 1207 Mandated Reporter Training certificate is valid until 11/11/2024. Licensee last completed an emergency disaster drill on 04/24/2024. 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.

CONTINUED ON 809-C

SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Laura Villanueva
LICENSING EVALUATOR SIGNATURE: DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/03/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SALINAS FCCH
FACILITY NUMBER: 566216566
VISIT DATE: 05/03/2024
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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

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.



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)/ (800) 514-0383
(TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the
ADA, available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee [or facility representative] and
discussed the Child Care Licensing Safe Sleep webpage at
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/
safe-sleep as an additional resource. LPA also informed licensee [or facility
representative] 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.

CONTINUED ON LIC809C

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

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: SALINAS FCCH
FACILITY NUMBER: 566216566
VISIT DATE: 05/03/2024
NARRATIVE
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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.

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.

A large family child care license is effective today. LPA reviewed capacity chart with Licensee. No deficiencies cited today. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Leticia Salinas.

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

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
LIC809 (FAS) - (06/04)
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