406213966-2-7-2020-17-CC-EBAY-BLKP4G-20200207095906

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406213966
Report Date: 02/07/2020
Date Signed: 02/07/2020 09:59:17 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:	HICKS FCC AKA LITTLE DUCKLINGS PRESCHOOL&CHILDCARE		FACILITY NUMBER:	406213966
ADMINISTRATOR:	DENINE HICKS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 544-4246
CITY:	SAN LUIS OBISPO	STATE: CA	ZIP CODE:	93401
CAPACITY:	14	CENSUS: 3	DATE:	02/07/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Denine Hicks		TIME COMPLETED:	10:15 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 February 7, 2020, at 8:30 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Annual/Random inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Denine Hicks, 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 dining room, living room, kitchen, living room bathroom and backyard are used for child care, while the garage, bedrooms and remaining bathrooms are excluded from child care. At the time of the inspection three children are present. Required licensing forms and documents are posted on the wall of the FCCH's living room. The FCCH's dining room has a fireplace which is screened by glass and inaccessible to children. LPA observed a smoke detector (living room and dining room) and carbon monoxide detector (living room) in the FCCH. Both detectors were tested and found to be operable. LPA observed a regulation fire extinguisher in the FCCH which was last serviced on August 28, 2019. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home was void of hazardous items and the bathroom the children use for care is clean and free of toxins. Medication in the FCCH is stored in the master bathroom which is inaccessible to children. LPA also observed cleaning compounds stored in elevated cabinets in both the living room restroom and kitchen. Each storage area is out of the reach of children. Toys, furniture and equipment observed are age appropriate. The backyard is enclosed by a wooden and wire fencing. Toys and play equipment viewed on site are age appropriate and in satisfactory condition. The fence’s entry/exit gate is secure. No bodies of water were observed on site. A sampling of the children records were reviewed. The records are current, complete and possessed 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: 02/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020

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: HICKS FCC AKA LITTLE DUCKLINGS PRESCHOOL&CHILDCARE	FACILITY NUMBER: 406213966
	VISIT DATE: 02/07/2020

NARRATIVE

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emergency contact information. The Licensee's records were also reviewed and found to be current and complete with CPR and First Aid certifications expiring on June 3, 2012. Licensee's Mandated Reporter certificate was current, with an expiration date of March 30 2020.

Licensee stated no firearms or ammunition are stored on site.

The Licensee is not providing Incidental Medical Services (IMS). Policy was discussed. 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 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 the parents of children in care. Licensee was reminded of the responsibility to know the regulations for FCCH 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: 02/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020

LIC809 (FAS) - (06/04)

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