406211099-4-6-2023-17-CC-EBAY-CQMV9Y-20230406161508

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406211099
Report Date: 04/06/2023
Date Signed: 04/06/2023 04:17:05 PM

Document Has Been Signed on 04/06/2023 04:17 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:	HIGGINS FAMILY CHILD CARE		FACILITY NUMBER:	406211099
ADMINISTRATOR:	REBECCA HIGGINS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 235-5589
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	14	CENSUS: 7	DATE:	04/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Rebecca Higgins		TIME COMPLETED:	02:26 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 04/06/23, at 2:25PM, Licensing Program Analysts (LPAs) Elvin Baddley and Giovani Gonzalez conducted a unannounced Required Annual inspection of the abovementioned Family Child Care Home (FCCH). LPAs met with Rebecca Higgins, Licensee of the FCCH and explained the purpose of the inspection. LPAs, in the company of Licensee, toured the interior and exterior of the FCCH. The home’s entire first story, specifically the home's living room, den, kitchen, and hallway restroom, is used for child care, while the home’s upper story is detached and excluded from care. At the time of the inspection LPAs observed seven (7) children on site. LPAs observed required licensing forms and documents posted on the wall near the FCCH's main entry. LPAs observed a combination smoke and carbon monoxide detector in the FCCH. The detector was tested at 2:35PM and found to be operable. The FCCH has a regulation fire extinguisher which was purchased on 11/11/22. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPAs reviewed the home’s fire/disaster drill log at 2:25 PM and noted the last fire/disaster drill occurred on 9/28/22, which is over six months from the present. LPAs reminded Licensee regulations call for emergency disaster drill to be completed every six months. LPAs observed age appropriate toys, furniture and equipment in the FCCH's interior. The home is void of hazards. LPA observed the restroom used by children in care to be clean and free of toxins. Medication is stored in the upper story of the home which is inaccessible to children and excluded from care. LPAs observed cleaning compounds on an elevated shelf in the restroom used for child care. LPAs observed the cleaning compounds to be beyond the reach of children in care. Sharps in the FCCH are stored on an elevated shelf in a cabinet which is beyond the reach of children. (LIC 809-C)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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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Document Has Been Signed on 04/06/2023 04:17 PM - It Cannot Be Edited

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: HIGGINS FAMILY CHILD CARE	FACILITY NUMBER: 406211099
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/06/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(9)(A)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation/ interview/ record review the licensee did not comply with the section cited above in that Licensee last completed an emergency disaster drill of 9/28/22, over six months from the present, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/20/2023
	Plan of Correction
1 2 3 4	Licensee will conduct an emergency disaster drill by 4/20/23, and submit a written plan to CCLD (elvin.baddley@dss.ca.gov) with regard to a procedure which will ensure the FCCH is completing emergency disaster drills pursuant to regulation time frame.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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: HIGGINS FAMILY CHILD CARE	FACILITY NUMBER: 406211099
	VISIT DATE: 04/06/2023

NARRATIVE

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The backyard is currently under renovation, therefore Licensee is not using backyard. No bodies of water are observed on site.

LPAs reviewed a sampling of children's and Licensee's records. The children's records are current and complete. A current roster of children was reviewed by the LPAs. The children noted in the roster were present and on site. The emergency contact information and immunization's of children in care is current. LPAs notes no sleep logs were completed since Licensee does not give care to children under the age of two. The Licensee's records are also current and complete with Pediatric CPR and First Aid (EMSA approved) certifications expiring on 08/10/22. LPA reviewed the Licensee's Mandated Reporter certificate which expires on 9/23/23. Licensee states there are no firearms in the home.

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 up to $500.00 maximum per day/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. 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.

CONT. LIC809-C (PAGE 3)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

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: HIGGINS FAMILY CHILD CARE	FACILITY NUMBER: 406211099
	VISIT DATE: 04/06/2023

NARRATIVE

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A Type B Deficiency is being cited based on LPAs' observation/interviews/record reviews pursuant to Title 22 of the CA Code of Regulations (refer to LIC 809-D). Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these rights. A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Rebecca Higgins

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2023

LIC809 (FAS) - (06/04)

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