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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406214989
Report Date: 02/27/2020
Date Signed: 02/27/2020 10:35:39 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:RAJ FAMILY CHILD CARE AKA LITTLE OSOS DAYCAREFACILITY NUMBER:
406214989
ADMINISTRATOR:CHRISTINA RAJFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 578-3810
CITY:LOS OSOSSTATE: CAZIP CODE:
93402
CAPACITY:14CENSUS: 8DATE:
02/27/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Christina and Christopher RajTIME COMPLETED:
10:30 AM
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On February 27, 2020, at 9:00 AM, Licensing Program Analyst (LPA) Elvin Baddley made an unannounced Case Management inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Christina and Christopher Raj , Licensees of the FCCH and discussed the purpose of the inspection, namely, the inspection was to follow up to a self reported incident involving a child in care (Child #1) falling from a play structure's (playhouse) opening (window) and sustaining an injury (scratched left cheek, laceration above left eyebrow) on February 12, 2020. LPA, in the company of the Licensees, toured the interior and exterior of the FCCH. LPA observed eight children in care at the time of the inspection.

LPA observed the area where the incident occurred (front yard) and play structure where Child #1 fell from. The window opening of the playhouse faced a portion of the front yard which has wooded chip at the base/ground. Licensees note aforementioned serves as cushioning for children playing. Licensees stated Child # 1 was attempting to mimic other children on site who where climbing other play structures during the time of the incident. After Child #1 fell from the playhouse window, the Licensee's applied pressure to the area bleeding and summoned the guardian/parent of Child #1. The guardian/parent of Child #1 transported Child #1 to the physician for medical attention. Child # 1 returned to the FCCH following the incident and , to date, has a small line over his eye brow which serves as a remnants of the fall/incident.

Following the incident, the Licensees repositioned the play house in a manner which the window opening is against a fixed yard fence. The repositioning makes it improbable a child can exit or fall from with structure's window opening in the future.

Given the LPA's observation's, along with interviews and record reviews, it is determined the Licensees' actions did not contribute to the incident or Child #1 injuries. Further, the Licensees acted in accordance with Title 22 regulations. No deficiencies were cited during todays inspection.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin BaddleyTELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2020
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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