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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215517
Report Date: 05/30/2019
Date Signed: 05/31/2019 09:28:53 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:COLLINS FCC AKA ABC CHILDCAREFACILITY NUMBER:
406215517
ADMINISTRATOR:MELINDA COLLINSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 547-4557
CITY:ARROYO GRANDESTATE: CAZIP CODE:
93420
CAPACITY:14CENSUS: 14DATE:
05/30/2019
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Melinda CollinsTIME COMPLETED:
04:35 PM
NARRATIVE
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Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced Plan of Correction Inspection. The purpose of the visit was discussed. LPA met with licensee, Melinda Collins. There were 14 children present. LPA observed Assistant, Melissa Bandurraga was not present, licensee stated she was at lunch. LPA observed the presence of Cherri Bohard, licensee stated she is covering for the assistant.

Based on LPA's review of facility personnel record, Ms. Cherri Bohard has no criminal record clearance. Interview with Ms. Bohard and Licensee revealed that Ms. Bohard started working today, May 30, 2019.

Based on review of children's record and interview with licensee, day care children present on May 30, 2019 were consist of 3 infants, 11 older children over the age of 2, there was no proof for school age children or children at least 6 years of age.

LPA observed the bedroom where 3 children were napping were in disarray, clothes were on the bed and floors were cluttered with clothes.

LPA reviewed children's file and observed that LIC 9224 Acknowledgement Receipt of a Type A Violations were filed on each children's file.
Continued on 809C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 4
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: COLLINS FCC AKA ABC CHILDCARE
FACILITY NUMBER: 406215517
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/10/2019
Section Cited
CCR
102417(b)
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(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.




This requirement is not met as evidenced by:
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Licensee agreed to clear the clutter and submit a written plan of correction to CCLD on or before 6/10/2019 to ensure that home is kept clean and in order.
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Based on LPA's observation, the bedroom where 3 children were napping was in disarray, clothes were on the bed and floor was cluttered with clothes. This poses a potential risk to health and safety of children in care.
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: COLLINS FCC AKA ABC CHILDCARE
FACILITY NUMBER: 406215517
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/30/2019
Section Cited
CCR
102370(d)(1)
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(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
(1) Obtain a California clearance or a criminal record exemption as required by the Department .
This requirement is not met as evidenced by:
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Ms. Bohard was advised not to have interaction with children. Licensee and Ms. Bohard agreed that Ms. Bohard must get criminal record clearance and submit all documents required for an assistant prior to working with daycare.
A $100 civil penalty was assessed
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Based on LPA's review of facility personnel record, Ms. Cherri Bohard has no criminal record clearance. Interview with Ms. Bohard and Licensee revealed that Ms. Bohard started working today, May 30, 2019.
This poses an immediate risk to health and safety of children in care.
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Type A
05/31/2019
Section Cited
CCR
102416.5(d)(2)(a)
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(d) For a Large Family Child Care Home,,..(2) More than twelve and up to fourteen children only if the criteria in Section 1597.465 are met. (a) At least one child is enrolled in and attending kindergarten or elementary school and a second child is at least six years of age.
This requirement is not met as evidenced by
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Licensee agreed to submit a written plan of correction to CCLD on 5/31/2019 on how to ensure that day care maintains the correct ratio and capacity. Licensee agreed to disenroll two children or arrange the schedule with parents to ensure compliance and to maintain the correct ratio and capacity. The schdule will be submitted to CCLD on 5/31/2019.
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 Based on review of children's record and interview with licensee, day care children present on May 30, 2019 were consist of 3 infants, 11 older children over the age of 2. Day care has no kindergarten nor a 6 year old child. This poses an immediate risk to health and safety of children in care.
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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 MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: COLLINS FCC AKA ABC CHILDCARE
FACILITY NUMBER: 406215517
VISIT DATE: 05/30/2019
NARRATIVE
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During today's inspection, deficiencies were cited under Title 22 Division 12 of California Code of Regulation. 809D

Upon receipt, provide copies of this licensing report to each parent/guardian of enrolled children and to parents/guardians of newly enrolled children during the next 12 months. Acknowledgement of Receipt LIC 9224 form shall be used for this purpose. LIC 9224 after completed shall be maintained in each child's file. (LIC 9224 was provided to the Family Child Care Home.)


The following deficiencies cited on May 17, 2019 annual/random inspection were corrected:
102417(g)(4): Operations of a Family Child Care Home: Licensee placed the cleaning compound and toxins into a covered plastic container and stored them in a locked cabinet.
102418 (g)/(g)(1): The Licensee started documenting and maintaining children's immunization in blue form, PM 286
1596.8662(b)(1): Licensee and Assistant took the AB 1207 Mandated Reporter Training on 5/27/19 and 5/29/19 respectively
102417(g)(1) Operations of a Family Child Care : Licensee purchased new fire extinguisher on 5/17/2019
102417(g)(8) Operations of a Family Child Care: Day care home is now maintaining children's roster as specified in Health and Safety Code Section 1596.841.

Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

LPAs observed licensee posted the Notice of Site Visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4