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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215307
Report Date: 06/30/2022
Date Signed: 06/30/2022 12:01:49 PM


Document Has Been Signed on 06/30/2022 12:01 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:LUIS FCC AKA MUNCHKINS DAYCAREFACILITY NUMBER:
406215307
ADMINISTRATOR:HEATHER LUISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 286-4452
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY:14CENSUS: 6DATE:
06/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Heather LuisTIME COMPLETED:
12:15 PM
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On June 30, 2022 at 10:20 AM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random inspection. LPA met with licensee Heather Luis and advised her the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. There was six (6) children in care during the inspection.

Licensee has a single story home. Licensee uses the living room, one (1) bedroom, one (1) bathroom, and the backyard for children in care. A 2A10BC fire extinguisher was observed mounted on the wall at the entrance of the facility with a service date of 5/13/22. LPA did not observe hazards/toxins accessible to children in care. Licensee stores the disinfectants/chemicals in a cabinet in the kitchen. The cabinet door has a child safety lock preventing children from having access. LPA observed age appropriate toys, books, and furniture readily accessible for children in care. Licensee has a large backyard with the children having their own enclosed yard with a wood fence. Licensee has age appropriate toys and play structures readily accessible for children in care when they are outside playing. There is a gate accessing to the other yard properly secured preventing children from having access.

LPA reviewed a sampling of children records. The children records were found to be current and complete. Licensee's Mandated Reporter expires on 10/4/22. Licensee's CPR/First-Aid expires on 1/31/23. The last fire drill was completed on June 1, 2022. Licensee is following current guidelines. Licensee was provided a Carbon monoxide resource.

No deficiencies were cited during today's inspection.

Continued on 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:
DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/30/2022
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: LUIS FCC AKA MUNCHKINS DAYCARE
FACILITY NUMBER: 406215307
VISIT DATE: 06/30/2022
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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 Home 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: http://www.ada.gov/childqanda.htm.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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 [facility representative] 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.

A notice of site visit was provided and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
LIC809 (FAS) - (06/04)
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