370815052-10-18-2019-51-CC-BSYA-BH3PEZ-20191018111557

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 370815052
Report Date: 10/18/2019
Date Signed: 10/18/2019 11:16:07 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	CARROLL, CAROL FAMILY DAY CARE		FACILITY NUMBER:	370815052
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	10/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:23 AM
MET WITH:	Carol Carroll		TIME COMPLETED:	11:20 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 10/18/19 at 10:23 a.m. Licensing Program Analyst (LPA) Brooke Sykora made an unannounced visit for the purpose of an Annual/Random inspection, as well as an increase in capacity. At the time of the inspection, there were two children in care with the Licensee, none of which were under the age of two. The Licensee's helper was also present at the time of the inspection. The facility is within ratio and capacity. LPA conducted a tour of the home to ensure compliance with standards established in CCR, Title 22, Division 12, Chapter 3. Hours of operation are Monday through Sunday 24 hours per day. Primary child care areas are living room, bathroom, kitchen, and the front portion of the backyard. Off limits areas have been made inaccessible with the use of key locks. There are no hazardous substances accessible. There are no weapons stored in the home or on the property. There is a jacuzzi located in the backyard with a locked cover that meets regulations. The fire extinguisher is full and of adequate size and located in the kitchen. The smoke detector and carbon monoxide detector, located in the in the main hallway, are operational. The home is clean, orderly and has adequate ventilation and heating. Licensee has provided sufficient space for the children to eat, sleep, and play within the home. Children’s toys and play equipment are safe and age appropriate. There is a working telephone and all required forms are posted. Children’s files were reviewed for emergency information. The last emergency drill was conducted on 10/03/19. The facility roster is current and complete. Licensee's pediatric CPR/First Aid certificate is valid through October 2021. Staff immunization requirements have been met. Licensee and the helper will need to complete the Mandated Reporter Training. SIDS/Safe Sleep was discussed and Safe Sleep handouts were provided. LPA and Licensee discussed California Megan's Law and LPA provided the following: www.meganslaw.ca.gov. Effect of Lead Exposure handout was provided and Licensee was advised to provide handout to parents/guardians of current and future enrollees. The facility does not currently provide Incidental Medical Services.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Brooke Sykora	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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, 7575 METROPOLITAN DR STE 110
SAN DIEGO, CA 92108

FACILITY NAME: CARROLL, CAROL FAMILY DAY CARE	FACILITY NUMBER: 370815052
	VISIT DATE: 10/18/2019

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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)/ (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

Licensee was reminded that walkers, exersaucers, jumpers, and bouncy seats are not permitted for use. Licensee was advised to regularly visit the Community Care Licensing website: http://www.ccld.ca.gov/ for quarterly updates and updated regulation information.

Southern California Child Care Advocate information was provided and Licensee was encouraged to subscribe to the email list on the CCLD website for updated regulation information. Advocate information was provided: (714) 703-2800 or childcareadvocatesprogram@dss.ca.gov.

No deficiencies were cited and an increase in capacity for a license for 14 will be issued. Fire clearance was granted on 09/30/19. An exit interview was conducted and a copy of this report was provided.

NOTICE OF SITE VISIT WAS POSTED AND MUST REMAIN POSTED FOR 30 DAYS.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Brooke Sykora	TELEPHONE: (619) 767-2218
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

LIC809 (FAS) - (06/04)

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