Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214052
Report Date: 08/02/2018
Date Signed 08/02/2018 02:43:05 PM

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:AYALA FCC AKA JULIE'S HOME DAY CAREFACILITY NUMBER:
426214052
ADMINISTRATOR:JULIE AYALAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 737-3040
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 10DATE:
08/02/2018
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Julie AyalaTIME COMPLETED:
02:50 PM
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A follow up visit was conducted by LPA S. Mendoza-Ceja who met with Licensee Julie Ayala in regards to the deficiencies cited on July 13, 2018. Upon arrival, LPA observed 10 children in care of which nine were eating lunch and one child napping. The home was toured inside and outside.

The following deficiencies are now cleared:
102423(a)(2) Personal Rights: Licensee submitted a statement stating she is aware car seat is used for transportation only.
102417(g)(4) Operation of a Family Child Care Home: Licensee placed latches and has made medications inaccessible to children.
102417(g) Operation of a Family Child Care Home: Licensee removed the cabinet and submitted a statement stating she understands the cabinet should have been secured.
1597.543 Health and Safety: Carbon Monoxide Detectors were purchased for the home and were tested on 08/02/2018
102417(g)(1) Operation of a Family Child Care Home: During the visit of 07/13/2018, Mr. Ayala purchased a 340 10 BC Fire extinguisher.
102417(g)(9)(A)(1) Operation of a Family Child Care Home: An emergency disaster drill was conducted and documented on 07/16/2018, in addition an updated emergency disaster plan was completed and posted for review.
102421 Child's Records: A review of files revealed they are complete. Licensee submitted a statement that she is no longer administering Vitamin C to the children.

Ms. Ayala was advised if any of the latches, or locks become ineffective, it is her responsibility to make the medications and off limit areas inaccessible to children.

In regards to immunization for licensee, an extension is granted until 08/10/2018.
The Notice of Site Visit was posted.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132 FAX 685-1820
LICENSING EVALUATOR SIGNATURE:

DATE: 08/02/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2018
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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