406214079-7-26-2021-17-CC-EBAY-C5AV5Q-20210726160818

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406214079
Report Date: 07/26/2021
Date Signed: 07/26/2021 04:08:33 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:	SMITH FAMILY CHILD CARE		FACILITY NUMBER:	406214079
ADMINISTRATOR:	MEGHAN MARGARET SMITH		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 440-8592
CITY:	ARROYO GRANDE	STATE: CA	ZIP CODE:	93420
CAPACITY:	14	CENSUS: 1	DATE:	07/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Meghan Smith		TIME COMPLETED:	04:15 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 7/26/21, at 2:15 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted a Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Meghan Smith, 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 home’s playroom, kitchen, guestrooms (2), hallway bathroom and backyard are used for child care, while the home’s master bedroom, garage and laundry room are excluded. At the time of the inspection one child (biological) is present. LPA observed required licensing forms and documents post on the wall in FCCH's playroom. The FCCH has no fireplace on site. A combination smoke/carbon monoxide detector is observed in the FCCH.'s playroom. The combination smoke/carbon monoxide detector was tested ( 2:45 PM) and found to be operational. LPA observed a regulation fire extinguisher in the FCCH's which was purchased 7/24/21. 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 drill occurred on the 3/17/21. The home was orderly and the bathroom used for care was clean and free of toxins. LPA observed cleaning compounds in the laundry room and underneath the the sink in a secure cabinet. LPA observed kitchen sharps on an elevated shelf in the pantry which isn locked and inaccessible to children in care. Medication is stored in the master bedroom's bathroom which is excluded from care.Toys, furniture and equipment in the FCCH are age appropriate. The FCCH's backyard is enclosed by wooden fencing. The fence’s entry/exit gates are secure. Toys and play equipment observed in backyard are age appropriate. The FCCH is in proximity to a community pool. The location of the community pool is just beyond outside of the FCCH's rear back yard fence. LPA observed the the community pool to be enclosed by wrought iron fencing and secure. (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: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

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: SMITH FAMILY CHILD CARE	FACILITY NUMBER: 406214079
	VISIT DATE: 07/26/2021

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LPA reviewed a sampling of the children records. All records reviewed are current and complete. A current
roster of children was reviewed by the LPA. The children noted in the roster were present and on site. Licensee also had logs capturing children's sleep in 15 minute intervals. LPA reviewed the Licensee's records. The Licensee's records are current and complete with Pediatric CPR and First Aid certifications expiring in 9/29/21 (EMSA approved) and Mandated Reporter training expiring on 7/25/23.

The Licensee informed LPA no firearm or ammunition is 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 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: 07/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021

LIC809 (FAS) - (06/04)

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