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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566216700
Report Date: 09/28/2023
Date Signed: 09/28/2023 11:14:03 AM

Document Has Been Signed on 09/28/2023 11:14 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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:ABUNDIS FAMILY CHILD CAREFACILITY NUMBER:
566216700
ADMINISTRATOR:MARIA ABUNDISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 890-9539
CITY:PORT HUENEMESTATE: CAZIP CODE:
93041
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
09/28/2023
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Maria Abundis TIME COMPLETED:
11:30 AM
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On September 28 2023, Licensing Program Analyst (LPA) Giovani Gonzalez conducted an announced prelicensing inspection at the above-mentioned residence. LPA met with applicant Maria Abundis and informed them the purpose of the inspection. Applicant informed the LPA the intention to maintain operating hours of the Family Child Care Home (FCCH) Monday - Saturday, 5AM - 6PM. Applicant has the intention of caring for children of 0 months- 13 years old. At the time of the inspection there were no children present.

LPA , in the of the applicant, toured the interior and exterior of the residence in its entirety. The residence is a 4 bedroom, 3 bathroom single story home with a detached garage. The home's living room, kitchen/dining area, and 1 bathroom will be used for child care purposes while the remainder of the home is excluded from care.

LPA observed the home to be clean and orderly. The home has sufficient spacing and ventilation for children in care. LPA observed a fire place that is blocked off and secured. LPA observed the kitchen to be clean and free of hazards. LPA observed the sharps and medication to be stored in an elevated kitchen cabinet beyond the reach of children. LPA observed the bathroom to be used for child care to be clean and free of toxins. All cleaning compound and detergents were observed in the detached garage that remains locked, therefore inaccessible to children.

LPA observed a regulation fire extinguisher (2A10BC) in the home which was purchased 8/8/23. LPA reminded applicant the responsibility to service or purchase a regulation fire extinguisher annually. The home has numerous smoke and carbon monoxide detectors. A smoke and carbon monoxide detector were tested at 9:38AM and found to be operable.

The home's backyard is enclosed by walls and a wooden gate. The gate is capable of being secured. LPA
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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2023
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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: ABUNDIS FAMILY CHILD CARE
FACILITY NUMBER: 566216700
VISIT DATE: 09/28/2023
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observed a pool in the backyard that is enclosed by a gate that is at least 5 feet tall. LPA observed that the self latching gate is functional and that the applicant keeps the latch locked.

LPA 's record review revealed the Applicant's Mandated Reporter Training was completed 4/5/23 (expiration 4/5/25) and Pediatric CPR/First Aid (EMSA approved) was completed 3/27/23 (expiration 3/27/25). LPA reminded applicant of the obligation to maintain current training and certificates. Applicant completed Preventative Health Training 6/15/23. Fire clearance was granted 9/12/23. LPA reviewed Applicant's control of property document (Closing Statement). Applicant does not have liability insurance at this time. LPA provided Applicant with Affidavit Regarding Liability Insurance form (LIC 282). Applicant informed LPA no firearms or ammunition are on site.


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

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

Applicants 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, 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 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


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SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
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
CENTRAL COAST-CHILD, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: ABUNDIS FAMILY CHILD CARE
FACILITY NUMBER: 566216700
VISIT DATE: 09/28/2023
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an additional resource. 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.

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 platform.

Applicant 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 applicant, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

Exit interview conducted and report was reviewed with the Applicant Maria Abundis. The home meets Title 22 Division 12 requirements of a Large FCCH License. Effective date of license will be noted as the present, 9/28/2023.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Giovani Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2023
LIC809 (FAS) - (06/04)
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