406214079-4-18-2024-17-CC-EBAY-D4FR57-20240418124241

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406214079
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:42:51 PM

Document Has Been Signed on 04/18/2024 12:42 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:	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: 8	DATE:	04/18/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Meghan Smith		TIME COMPLETED:	01:00 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 4/18/24, at 10:45 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an Annual/Random 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, hallway bathroom and backyard are used for child care, while remainder of the home is excluded from care. At the time of the inspection, LPA observed 8 children in care along with an Assistant (cleared and associated) providing care and supervision. 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 is locked and inaccessible to children in care. Medication is stored in the master bedroom of the home, which is excluded from care. Toys, furniture and equipment in the interior of the FCCH are age appropriate. The FCCH was working telephone service. 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 detector was tested at 11:30 AM and found to be operational. LPA observed a regulation fire extinguisher in the FCCH's which was purchased 4/10/24. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH's backyard is enclosed by wooden fencing and the footing is the area is varied. The fence’s entry/exit gates are secure. 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 community pool to be enclosed by wrought iron fencing and secure. The pool is not used by children in care. Further, there no body of water on the property of the FCCH. Toys and play equipment observed in backyard are age appropriate. LPA informed the Licensee to replace outdoor play equipment and toys once the began to degrade and are not in good repair. (CONT. 809-C, Page 2)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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: 04/18/2024

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LPA reviewed children records. All records reviewed are current and complete, with immunization records and emergency consent forms, among other required documents. A current roster of children was reviewed by the LPA. LPA reviewed the Licensee's records. The Licensee's records are current and complete with Pediatric CPR and First Aid certifications expiring in 10/25/24 (EMSA approved) and Mandated Reporter training expiring on 7/25/25. The Licensee informed LPA no firearm or ammunition is on site.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (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.

LPA 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 additional resource. LPA 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.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 4/9/24.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Meghan Smith.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC809 (FAS) - (06/04)

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