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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213219
Report Date: 12/15/2021
Date Signed: 12/15/2021 12:57:38 PM

Document Has Been Signed on 12/15/2021 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:GUZMAN FAMILY CHILD CAREFACILITY NUMBER:
426213219
ADMINISTRATOR:ARMIDA GUZMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 934-0894
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
12/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:52 AM
MET WITH:Maria Guzman EnriquezTIME COMPLETED:
01:10 PM
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Due to COVID-19 pandemic, LPA asked the pre-screening questions prior to inspection. Licensee's daughter responses indicate there was no COVID-19 exposure on site.

On 12/15/2021, at 11:52 AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Required Annual Inspection of the Guzman Family Child Care Home. LPA met with Maria Guzman Enriquez, licensee's daughter. The purpose of the visit was discussed with the Licensee's daughter and together we toured the inside and outside of the home. LPA observed no children in care at the time of the inspection.

Ms. Guzman-Enriquez states that licensee had a family emergency in Mexico. The FCCH has been closed since December 3, 2021. Ms. Guzman-Enriquez stated that licensee does not have a return date as of yet.

Licensee has a 2A10BC fire extinguisher, smoke detector and carbon monoxide detector. Licensee was reminded to service or replace the fire extinguisher yearly.

LPA discussed the requirement for all care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, and Measles. LPA also discussed the new Mandated Reporter training requirements. LPA provided and reviewed the Care Provider's Guide to Safe Sleep Handout with Ms. Guzman-Enriquez.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/15/2021
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: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426213219
VISIT DATE: 12/15/2021
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LPA attempted to contact Armida Guzman, Licensee, via telephone call during the inspection, but the calls failed.

LPA emailed licensee, and Ms. Guzman-Enriquez LIC 9211. LPA also provided Ms. Guzman-Enriquez an LIC 9211 (Request for Inactive), during the inspection.

LPA reviewed the handout "A Child Care Provider's Guide to Safe Sleep." LPA provided a Handout for Reporting Child Abuse and Neglect Training provided on line at www.ccld.ca.gov. The inspection visit was conducted in Spanish and report was translated in Spanish by LPA Jimenez.

There were no deficiencies cites at this time. LPA observed licensee post the Notice of Site visit FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021
LIC809 (FAS) - (06/04)
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