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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213219
Report Date: 11/14/2024
Date Signed: 11/14/2024 02:13:37 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/14/2024 02:13 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/
DIRECTOR:		ARMIDA GUZMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 934-0894
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 0DATE:
11/14/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:20 PM
MET WITH:Armida GuzmanTIME VISIT/
INSPECTION COMPLETED:
02:25 PM
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On November 11, 2024, Licensing Program Analyst (LPA) Martina Jimenez conducted an unannounced Triennial inspection at above Family Child Care Home (FCCH). LPA met with Armida, Guzman licensee, Alfredo Guzman, Assistant/husband, and Maria Guzman Enrique, daughter. LPA discussed the purpose of the inspection and together LPA and licensee toured the inside and outside of the home. She states that the last day that licensee provided care was July 3, 2021.

A tour of the home was made both inside and outside. 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 Mandated Reporter training requirements. LPA provided and reviewed the Care Provider's Guide to Safe Sleep (PIN 20-24-CCP-SP) Handout with Licensee. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided on line at www.ccld.ca.gov.


Continues on LIC809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE: DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GUZMAN FAMILY CHILD CARE
FACILITY NUMBER: 426213219
VISIT DATE: 11/14/2024
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Licensee requested for the FCCH license to be on Inactive Status. Licensee submitted LIC 9211 (Request for Inactive Child Care License Status) to LPA during the visit.

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: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC809 (FAS) - (06/04)
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