406213645-7-9-2021-17-CC-EBAY-C4RMSG-20210709095155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406213645
Report Date: 07/09/2021
Date Signed: 07/09/2021 09:52:03 AM

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:	EVANOFF FAMILY CHILD CARE		FACILITY NUMBER:	406213645
ADMINISTRATOR:	EVANOFF, RHONDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 541-0907
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93405
CAPACITY:	14	CENSUS: 3	DATE:	07/09/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Rhonda Evanoff		TIME COMPLETED:	10:00 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 7/9/21, at 8:15 AM Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Licensee Rhonda Evanoff and explained the purpose of the inspection. LPA, in the company of Licensee and Assistant toured the interior and exterior of the FCCH. The FCCH’s converted guest room, dining room, living room, backyard, converted garage and hallway restroom are used for childcare services, while the home’s upstairs is excluded from child care. At the time of the inspection three children are present along with Assistant/spouse Joshua Evanoff. The home is clean, orderly and has ample ventilation to support the children’s comfort and safety. LPA observed the home is void of hazardous items. Medication is stored on an elevated shelf in a kitchen cabinet which is above the refrigerator. The aforementioned is beyond the reach of children in care. Medication is also stored in the bathroom of the master bedroom which is inaccessible to children in care. LPA also observed cleaning compounds stored underneath the kitchen sink which is secured by a child safety lock. Sharps in the kitchen area are stored along side medication an elevated shelf in a kitchen cabinet which is above the refrigerator and beyond the reach of children in care. Toys, furniture and equipment observed in the FCCH are age appropriate. Required forms are predominantly posted on the converted guest room wall of the FCCH. LPA observed a fireplace in the living room which is screened by glass. Additionally, LPA observed a child safety gate at the base of the stairwell which serves as a barrier to the home's upstairs. LPA observed the restroom used for care to be free of toxins and hazards. The FCCH has smoke and carbon monoxide detectors which were tested (8:40 AM and 8:42 AM) and found to be operable. LPA observed a regulation fire extinguisher in the FCCH which was service on 4/27/21. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log. The most recent fire/disaster drill occurring on 6/21/21. The FCCH maintains operable 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: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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: EVANOFF FAMILY CHILD CARE	FACILITY NUMBER: 406213645
	VISIT DATE: 07/09/2021

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The backyard is enclosed by wooden fencing. The fence’s entry/exit gates are secure. The back yard also has three sheds which contains yard tools, equipment and supplies. The sheds were all secured by lock. LPA observes a trampoline on site. The trampoline was behind a secure gate and the Licensee noted the trampoline is not used by children in care. The back yard contains a converted garage which is equipped with child appropriate toys and furnishing. Likewise, toys, equipment and play structures observed in backyard are age appropriate. No bodies of water are observed on site.

A sampling of the children records were reviewed. The records are current and complete. A current roster of children was reviewed by the LPA and children on site are contained in the roster. LPA also reviewed the Licensee’s records which are current and complete with Pediatric CPR and First Aid certifications expiring on 1/28/23, and Mandated Reporter Training expiring 7/8/23. LPA also observed two dogs on site. The vaccination records for the dogs were reviewed and found to be current. A firearm and ammunition is on stored on site. The aforementioned are secured and stored separately.

The Licensee is not providing 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: www.ada.gov/childqanda.htm

LPA discussed COVID 19 guidance and best practices with the Licensee. Licensee was reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

LIC809 (FAS) - (06/04)

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