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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215551
Report Date: 07/19/2019
Date Signed: 07/19/2019 04:56:47 PM

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:FISCHER FCC AKA SMALL MIRACLES CHILD CAREFACILITY NUMBER:
406215551
ADMINISTRATOR:JENNIFER FISCHERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 952-5351
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:14CENSUS: DATE:
07/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Chanel CooperTIME COMPLETED:
05:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Melissa Stewart conducted an unannounced annual/random inspection. Upon arrival, LPA explained the reason for the visit. S1 was alone with two napping infants. S1 reported that Licensee is out of town and Chanel Cooper had stepped out to run an errand around 1pm, after the infants had gone down for a nap at 12:30pm. Chanel Cooper arrived at approximately 2:30pm. The home was toured inside and out. All required forms are posted in a prominent location.

The day care area is located in the back area of the home. LPA observed age appropriate toys, games, books, napping equipment, tables and chairs. The bathroom used by children was observed to be clean and free of toxins. The bathroom is located adjacent to the laundry room. Cleaning products are stored out of reach of children. The kitchen, dining room, living room and bedrooms are off limits to children and are made inaccessible by a door. There is a small room with three pack n play cribs for napping infants. There are cots for older children to nap in the indoor activity area. The outdoor play area is completely fenced. LPA observed age appropriate play structure with cushioning. LPA observed toys and shade area. Water is available to the children using their own cups both inside and outside. There are no bodies of water.

Fire extinguisher was serviced on 10/09/18. Carbon monoxide and smoke detectors were tested and operational. Ms. Cooper stated there are no guns or ammunition in the home. Ms. Cooper's CPR expired on 2/1/2019. Cont. 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
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: FISCHER FCC AKA SMALL MIRACLES CHILD CARE
FACILITY NUMBER: 406215551
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/19/2019
Section Cited
CCR
102416(d)
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Personnel Requirements- Prior to employment or initial presence in the child care home, all employees and volunteers subject to a criminal record review shall:Obtain a California clearance or a criminal record exemption as required by law or Department regulations.

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S1 was provided with LIC 9163 LIVE SCAN form and indicated that she understands that she must not be present at the family child care home when children are present without a criminal record clearance.
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This requirement was not met as evidenced by LPA observation of S1 being alone with two infants and not having a criminal record clearance per licensing information system report of cleared persons. S1 reported that she has been working every Thursday and Friday since the beginning of June. S1 was alone with two infants for over one hour.
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This poses an immediate risk to the 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: Melissa K StewartTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
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: FISCHER FCC AKA SMALL MIRACLES CHILD CARE
FACILITY NUMBER: 406215551
VISIT DATE: 07/19/2019
NARRATIVE
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 Ms. Cooper has met immunization requirement per SB 792 and completed AB 1207 Mandated Reporter Training on 9/26/18. Children's records were randomly reviewed and found complete. Licensee provides snacks and parents provide lunch for their child. Licensee has a current CPR card which expires on 10/20/19.

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 reviewed and provided “Effects of Lead Exposure” to be distributed to all families. It is the responsibility of the Licensee to know the California Code of Regulations, Health and Safety Codes. Quarterly Updates and Provider Information Notices (PINs) can be accessed on-line at www.ccld.ca.gov.

The following Type A and B deficiencies are cited on page #2 and #3 according to CCR, Title 22 Division 12 Regulations and Health and Safety Code. Appeal rights provided. Upon receipt, post and provide copies of this licensing report: to parents/guardians of children in care at the facility and to parents/guardian of children newly enrolled at the facility during the next 12 months. Licensee shall obtain signatures of parents/guardian on the Acknowledgement of Receipt of Licensing Reports LIC 9224.


LPA observed the Notice of Site Visit posted.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
LIC809 (FAS) - (06/04)
Page: 4 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: FISCHER FCC AKA SMALL MIRACLES CHILD CARE
FACILITY NUMBER: 406215551
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/19/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2019
Section Cited
CCR
102416(c)
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The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement was not met as evidenced by review of Ms Cooper's CPR card
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Ms. Cooper indicates that she understands that she may not be alone with children without a current CPR certification.



This poses a potential risk to the health and safety to children in care.
Type B
08/02/2019
Section Cited
HSC
1596.7995
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Employees or volunteers immunization requirement- a person shall not be employed or volunteer at a day care center 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.
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Ms. Cooper indicated that she understands that S1 must provide documentation of immunizations prior to providing care to children. Documentation can be emailed to LPA.
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This requirement was not met as evidenced by S1 having no employee file and S1 statement that Licensee did not request any documentation from her prior to providing care and supervision to children.

This poses a potential risk to the health and safety to 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: Melissa K StewartTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4