406215396-6-16-2022-17-CC-GRES-CFFQR5-20220616122318

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215396
Report Date: 06/16/2022
Date Signed: 06/16/2022 12:23:24 PM

Document Has Been Signed on 06/16/2022 12:23 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:	TAYLOR FCC AKA CREATIVE LEARNING CHILDCARE		FACILITY NUMBER:	406215396
ADMINISTRATOR:	CINDY ANN TAYLOR		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(559) 860-9132
CITY:	ATASCADERO	STATE: CA	ZIP CODE:	93422
CAPACITY:	14	CENSUS: 8	DATE:	06/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Cindy Taylor		TIME COMPLETED:	12:25 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 6/16/2022 at 9:20 AM, Licensing Program Analyst Gigi Reyes conducted an unannounced 1 Year Required inspection and met with Licensee, Cindy Ann Taylor. LPA asked pre screening questions related to COVID- 19 and licensee’s responses indicate there are no COVID 19 exposures on site. LPA discussed the purpose of the inspection. There were 8 children 4 of whom were infants and 2 staff present during the inspection. LPA in the company of Licensee toured the interior and exterior of the day care. LPA observed that now FCCH uses the living room, a day care room area, bathroom and backyard for day care. Licensee stated a new facility sketch was mailed to Community Care Licensing Office a copy of which is posted in the home. LPA observed required licensing forms are posted in the FCCH. LPA observed smoke and carbon monoxide detectors in the home. Bathroom is toxin free. The regulation fire extinguisher was serviced on 6/16/2022.. Home conducts and documents fire and disaster drill every 6 months last drill was conducted on 12/21/2021. The backyard is enclosed by wooden fence and partial wire fence. LPA observed age appropriate toys and play equipment. No bodies of water were observed on site. Licensee stated guns and ammunition are separately stored in a safe. LPA Reyes reviewed facility file, Pediatric CPR and First Aid expires on 8/7/2023. Licensee and Assistant renewed the Mandated Reporter Training Certificate which expires on 3/4/2024. Assistant does not have proof of immunization on file. FCCH has current roster of children in care. The children's records were reviewed and found to be current. File contains Emergency and Identification card requirements. Currently the licensee carries liability insurance. Infants have complete Individual Safe Sleep Plan, Licensee checks and documents napping infants every 15 minutes. Continued on 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

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: TAYLOR FCC AKA CREATIVE LEARNING CHILDCARE	FACILITY NUMBER: 406215396
	VISIT DATE: 06/16/2022

NARRATIVE

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During today's inspection, deficiency was cited and a Technical violation was issued.

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.

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 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.

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

Exit interview conducted and report was reviewed with the licensee, Cindy Taylor.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/16/2022 12:23 PM - It Cannot Be Edited

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: TAYLOR FCC AKA CREATIVE LEARNING CHILDCARE	FACILITY NUMBER: 406215396
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above, assistant does not have the proof of immunization on file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/27/2022
	Plan of Correction
1 2 3 4	Licensee agreed to obtain the copy of assistant's immunization record and submit acopy to Community Care Licensing no later than 6/27/2022.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022

LIC809 (FAS) - (06/04)

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