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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426216015
Report Date: 07/23/2024
Date Signed: 07/23/2024 03:57:54 PM

Document Has Been Signed on 07/23/2024 03:57 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:MUNIZ FAMILY DAY CAREFACILITY NUMBER:
426216015
ADMINISTRATOR/
DIRECTOR:		MARIA ELENA MUNIZFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 862-9417
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
07/23/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Maria Elena Muniz and Antoinette MunizTIME VISIT/
INSPECTION COMPLETED:
03:36 PM
NARRATIVE
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On 7/23/2024 at 2:05 PM, Licensing Program Analyst (LPA Gigi Reyes conducted an unannounced Case Management Inspection at the above Family Child Care Home and met with co Licensee Maria Elena Muniz. LPA discussed with co-licensee the purpose of the inspection. LPA observed nine children under the care of co-Licensee Maria Elena Muniz. LPA was informed that licensee Antoinette Muniz had gone to run an errand in the nearby establishment who returned home around 2:25 PM with Child # 10 with her.

LPA discussed with Antoinette Muniz that FCCH was over capacity with 9 children present and only one staff member supervising. Licensee Antoinette stated that her middle school age child qualifies to be an assistant as verified with Resource and Referral. LPA provided licensee the regulation "Definition" 102352 (a) (3) "Assistant Provider" means a person at least 14 years of age who is primarily involved in caring for children during the hours that the home provides care"

During today's case management inspection, Type A Deficiency was cited under Title 22 Division 12 of California Code of Regulations.


Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: MUNIZ FAMILY DAY CARE
FACILITY NUMBER: 426216015
VISIT DATE: 07/23/2024
NARRATIVE
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LPA Reyes informed licensee, Antoinette Muniz that this report dated 7/23/2024 documents one (1) Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Reyes informed the licensee, Antoinette Muniz to provide a copy of this licensing report dated 7/23/2024 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with Licensee, Antoinette Muniz
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
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Document Has Been Signed on 07/23/2024 03:57 PM - It Cannot Be Edited


Created By: Gigi Reyes On 07/23/2024 at 02:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: MUNIZ FAMILY DAY CARE
FACILITY NUMBER: 426216015

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/23/2024
Section Cited
CCR
102416.5(b)(3)&e

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102416.5 Staffing Ratio and Capacity
(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following:
(3) More than six and up to eight children, without an additional adult attendant, only if the criteria in Section 1597.44 of the Health and Safety Code are met. (e) If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c).
This poses a potential risk to health and safety of children in care
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Upon arrival of Licensee, Antoinette Muniz at the FCCH, deficiency was corrected. However, a written plan of correciton shall be submitted no later than 7/23/2024.
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 Upon arrival at the FCCH LPA observed that co Licensee Maria Elena Muniz was caring for 9 children, Child # 1 to Child # 9. 15 minutes later, co licensee Antoinette Muniz arrived with Child # 10. This poses and immediate risk to health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Maria Mueller
LICENSING EVALUATOR NAME:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 07/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/23/2024


LIC809 (FAS) - (06/04)
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