406215087-10-3-2019-17-CC-MKST-BGLNE9-20191003102335

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215087
Report Date: 10/03/2019
Date Signed: 10/03/2019 10:23:41 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:	HILL FAMILY CHILD CARE		FACILITY NUMBER:	406215087
ADMINISTRATOR:	PORCHE HILL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 712-6505
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	14	CENSUS: 6	DATE:	10/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Porche Hill		TIME COMPLETED:	10:25 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	Licensing Program Analyst (LPA) Melissa Stewart conducted an unannounced annual/random inspection and met with Porche Hill and her Assistant. The home was toured inside and out. All required forms are posted in a prominent location. There were 6 children present, 2 being infants. There are 2 bedrooms and 2 bathrooms. The bedrooms and bathroom upstairs are off limits to day care children and are made inaccessible to by a gate. In addition, the bedroom doors are kept locked during day care hours. The bathroom used by children was observed to be clean and free of toxins. LPA observed age appropriate toys in the living room which is used for day care. All hazardous items are stored inaccessible to children in care. Licensee stated there are no guns or ammunition in the home. Licensee reported that children play in the front yard (not fenced), supervised by an adult at all times. There are no bodies of water. Fire extinguisher was serviced on 8/26/19. Carbon monoxide and smoke detectors were tested and operational. Licensee completes and documents emergency drills. The most recent drill was held on 6/13/19. Licensee and assistant have current CPR and first aid certification expiring on 7/19/21. Licensee and assistant have met immunization requirement per SB 792 and completed Mandated Reporter Training on 2/20/18. Children's records were randomly reviewed and found complete. Continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

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: HILL FAMILY CHILD CARE	FACILITY NUMBER: 406215087
	VISIT DATE: 10/03/2019

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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 reviewed and provided Licensee with a copy of “Child Care Providers Guide to Safe Sleep.” LPA provided “Effects of Lead Exposure” to be distributed to all families. Licensee was advised to review Quarterly Updates and Provider Information Notices (PINs) which can be accessed on-line at www.ccld.ca.gov.

In the areas evaluated, no deficiency cited.

LPA observed Licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC809 (FAS) - (06/04)

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