406210090-12-3-2019-17-CC-EBAY-BJHUJE-20191203143724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406210090
Report Date: 12/03/2019
Date Signed: 12/03/2019 02:37:37 PM

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:	BALLWEBER FCC AKA JESSIE'S FAMILY DAYCARE		FACILITY NUMBER:	406210090
ADMINISTRATOR:	JESSICA BALLWEBER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 545-9301
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	14	CENSUS: 8	DATE:	12/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Jessica Ballweber		TIME COMPLETED:	02:45 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 December 3, 2019, at 1:00 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted a unannounced Annual/Random inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Jessica Ballweber, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of the licensee, toured the interior and exterior of the FCCH. The FCCH's family room, bedrooms, backyard and hallway restroom are used for child care services. The kitchen and garage are excluded from child care. At the time of the inspection, eight children are present (all napping). A sampling of the children records were reviewed. The records were current, complete and possessed emergency contact information as mandated by regulations. The Licensee records are also current and complete with Pediatric CPR and First Aid certifications expiring on 1/30/21. The home was orderly and had ventilation to afford for the children’s comfort and safety. Medication at the FCCH is stored in a kitchen cabinet on an elevated shelf. Cleaning products and compounds are also stored on elevated shelves in the home's hallway closet and kitchen cabinet. Toys, furniture and equipment observed in the FCCH's interior are age appropriate. The backyard has an artificial grass padded surface. The backyard is enclosed by wooden fencing. The back yard is partitioned to afford an area for gardening and an excluded area which is inaccessible to children. Toys and play equipment observed in backyard are age appropriate and absent of hazards. No bodies of water are observed on site. Required forms are posted on a bulletin board in the family room. LPA observed operable smoke and carbon monoxide detectors in the FCCH's family room. The FCCH has a regulation fire extinguisher which was service on 1/30/19. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

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, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: BALLWEBER FCC AKA JESSIE'S FAMILY DAYCARE	FACILITY NUMBER: 406210090
	VISIT DATE: 12/03/2019

NARRATIVE

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The Licensee stated no firearms or ammunition are present or stored on site.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. When any IMS is pf 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: www.ada.gov/childqanda.htm

LPA reviewed and provided Licensee with a copy of “Child Care Providers Guide to Safe Sleep." LPA reviewed and provided “Effects of Lead Exposure” to be distributed to all families. Licensee was reminded of the responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, no deficiencies observed.
LPA observed licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2019

LIC809 (FAS) - (06/04)

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