566217251-12-12-2024-17-CC-GNEE-DBVU47-20241212141439

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566217251
Report Date: 12/12/2024
Date Signed: 12/12/2024 02:14:53 PM

Document Has Been Signed on 12/12/2024 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	CRUZ FAMILY CHILD CARE		FACILITY NUMBER:	566217251
ADMINISTRATOR/ DIRECTOR:	CRUZ RODRIGUEZ, LIVIER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 980-8545
CITY:	VENTURA	STATE: CA	ZIP CODE:	93004
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 2	DATE:	12/12/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:17 PM
MET WITH:	Livier Cruz Rodriguez		TIME VISIT/ INSPECTION COMPLETED:	02:28 PM

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On 12/12/2024 Licensing Program Analyst (LPA) German Negrete conducted an announced pre-licensing/Change of location inspection for a Large Family Child Care Home (FCCH) license. Applicant was previously licensed at another home in Ventura L#566216409. LPA met with Applicant. The purpose of the inspection was discussed and together LPA and License toured the inside and outside of the home. There were two children (blood relatives) in care at the time of the inspection. Applicant states there is one adult living in the home, a the adult currently has a fingerprint background clearance.

Applicant requested a Large FCCH license. The home is a single-story home that consists of Bedroom#1, Bedroom#2, Bedroom#3, Bedroom#4 hallway bathroom, living room, kitchen, dining room, garage and outdoor play area that is fenced off. The areas used for day-care are as followed, Bedroom#1, living room, dining room, hall way bathroom and outdoor play area(yard).

The off limits areas consist of Bedroom#2, bedroom #3, Bedroom#4, garage and Kitchen. LPA observed door knob locks on Bedroom#2, #3, #4, Bathroom#2 and Garage door, making the bedrooms, bathrooms and garage inaccessible to day care children. The kitchen had two child proof barriers making the kitchen inaccessible to day care children(see LIC812). The knives are stored in a locked kitchen cabinet making these items inaccessible to children in care. There are no bodies of water on the property. Applicant stated there are no fire arms or ammunition in the home. Continued on LIC809-C (pg.2)

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 566217251
	VISIT DATE: 12/12/2024

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LPA observed that the FCCH is clean and orderly, LPA did not observe clutter. In addition, there is plenty of ventilation for the children in care due to AC and Heater ventilation system(inaccessible to Children). LPA did not observe any toxins nor hazardous items accessible to children. Continued on 809-C(page2)

LPA observed medication stored in bedroom#4, making medication inaccessible to day care chidlren. Cleaning compounds were observed inside a locked kitchen cabinet, making the cleaning compounds inaccessible to day care children.

The bathroom to be used for children in care was observed to be clean and free of toxins. LPA observed that home has age-appropriate chairs, tables, equipment, toys and other materials for child care activities.

LPA and Applicant toured the outdoor play area. The outdoor play area is completely fenced.

No prohibited equipment will be allowed or used in the home. No baby bouncers, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

LPA observed a regulation 2-A-10-B-C fire extinguisher in the FCCH at the time of the inspection that was purchased on 11/23/2024 . Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed that the applicant tested the dual smoke and carbon monoxide detectors in the home at 1:02PM and were functioning at the time of the inspection.

Applicant is current with immunization required per SB792. The Applicant completed the Orientation on 03/12/2022. Applicant Pediatric First Aid/CPR certificate is valid until 10/26/2026 Applicant took the Preventative Health on 05/21/2022. Applicant’s Mandated Reporter Training certificate is valid until 10/15/2026. Continued on LIC809-C (page3)

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 566217251
	VISIT DATE: 12/12/2024

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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 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.

On this date, 12/12/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

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.

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. Continued on LIC809-C(page 4)

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 566217251
	VISIT DATE: 12/12/2024

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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.

The Applicant provided lease agreement on 12/11/2024. The Applicant rents the home.

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.

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.

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. Continued on LIC809-C(pg.5)

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: CRUZ FAMILY CHILD CARE	FACILITY NUMBER: 566217251
	VISIT DATE: 12/12/2024

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Exit interview conducted and report was reviewed with Applicant .

The home meets Title 22 California code of regulations for a large FCCH license.

The Large License will be pending managers review.

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.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: German Negrete
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024

LIC809 (FAS) - (06/04)

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