401709271-9-30-2024-17-CC-MSAN-D9LTAH-20240930143335

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 401709271
Report Date: 09/30/2024
Date Signed: 09/30/2024 02:34:07 PM

Document Has Been Signed on 09/30/2024 02:34 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	JORDAN FAMILY CHILD CARE		FACILITY NUMBER:	401709271
ADMINISTRATOR:	JORDAN, NATALIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 466-4244
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY:	14	CENSUS: 9	DATE:	09/30/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:35 PM
MET WITH:	Natalie Jordan		TIME COMPLETED:	03:00 PM

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 09/30/24, at 12:25 PM, Licensing Program Analysts (LPAs) Elvin Baddley and Matthew Sapien conducted an unannounced Annual Random inspection of the abovementioned Family Child Care Home (FCCH). LPAs met with Natalie Jordan, Licensee of the FCCH, and explained the nature and purpose of the inspection. The LPAs, in the company of Licensee, toured the interior and exterior of the FCCH. The house is a 3 bedroom and 2 bathroom single story dwelling. The home’s living room, classroom (converted living space), one bathroom, and backyard are used for child care while the remainder of the FCCH is excluded. At the time of the inspection, nine children and one staff assistant were present. LPAs observed the FCCH to be clean and orderly. The bathroom, which is used for care, is clean and free of toxins. LPAs observed cleaning compounds in an elevated kitchen cabinet that is inaccessible to children in care. Sharps and medication (including a First Aid Kit) are also observed in the kitchen area in one of the cabinets in an elevated position beyond the reach of children in care. LPAs observed age-appropriate toys, furnishings, and equipment throughout the FCCH. LPAs observed licensing forms and documents posted prominently to a board at the entry of the living room. LPAs also observed several smoke and carbon monoxide detectors throughout the FCCH. The smoke detector and carbon monoxide detector were not tested as children in care were napping. Licensee informed LPAs that smoke and carbon monoxide detectors were last tested on 9/21/24 LPAs observed a regulation fire extinguisher in the FCCH which was last serviced on 5/29/24. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPAs reviewed the FCCH's fire/disaster drill log. The most recent fire drill occurred on 9/30/24. A wood-burning stove is located in the living room of the FCCH and is covered by a plastic screen which makes it inaccessible to children in care. Additionally, the Licensee informed LPA's that the wood-burning stove is not used. The FCCH's backyard is enclosed by wooden fencing. The fence’s entry/exit gates are secure. The footing in the backyard area is made up of varying surfaces. (CONT. 809-C, Page 2)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Matthew Sapien	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: JORDAN FAMILY CHILD CARE	FACILITY NUMBER: 401709271
	VISIT DATE: 09/30/2024

NARRATIVE

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LPAs observed a secured door in the back yard that leads to the house's living room. Toys and play equipment observed in backyard are age appropriate. LPAs observed and confirmed there are no bodies of water on site.

LPAs reviewed children's records. All records reviewed are current and complete. A current roster of children was reviewed by the LPAs as was documentation noting infant's immunization records amongst other required licensing documents and forms. LPAs also reviewed the Licensee's records. The Licensee's Pediatric CPR and First Aid certifications expiring on 10/30/24 (EMSA approved) and Mandated Reporter Training expiring on 8/1/25 are current and complete, as are other licensing forms and documents. LPAs reminded Licensee to keep certifications up to date. LPAs observed one dog present on site. While the dog doesn't have interactions with the children in care, the licensee indicates that the dogs vaccinations are up to date. Licensee informed LPAs that there are no firearms or ammunition on site.

The Licensee does not currently provide Incidental Medical Services (IMS). 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 all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPAs discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an for additional resource. (CONT. 809-C, Page 3)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Matthew Sapien	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: JORDAN FAMILY CHILD CARE	FACILITY NUMBER: 401709271
	VISIT DATE: 09/30/2024

NARRATIVE

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LPAs also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility when LPAs completed an RSO profile in FAS on 9/30/24.

A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Natalie Jordan.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR NAME: Matthew Sapien	TELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2024

LIC809 (FAS) - (06/04)

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