406215627-10-22-2019-17-CC-MKST-BH7PK8-20191022112242

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215627
Report Date: 10/22/2019
Date Signed: 10/22/2019 11:22:52 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:	ECKMAN FAMILY CHILD CARE		FACILITY NUMBER:	406215627
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 3	DATE:	10/22/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Katie Eckman		TIME COMPLETED:	11:30 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 made an unannounced inspection of the home and met with Licensee, Katie Eckman, to conduct an Annual/Random inspection. The purpose of the inspection was explained. The home was toured inside and out. The home has 3 bedrooms and 2 baths. LPA observed three pack n play cribs and age appropriate toys in the living room which is used for indoor activities. The dining area in the open plan kitchen is used for meals and snacks. Bathroom used by children was observed to be clean a free of toxins. The 3 bedrooms and en suite bathroom are not accessible to the children in care and are separated by gates and child proof door knob locks. The backyard is completely fenced and is equipped with age appropriate play structures and toys. There is a fence which retains licensee's two dogs outside of the outdoor activity area. Licensee reported that both dogs are up to date with vaccinations. Toxins and other hazardous items are stored inaccessible to children in care. Licensee stated there are no guns or ammunition in the home. There are no bodies of water. All adults living in the home have criminal record clearances. Fire extinguisher was serviced on 2/26/19. Licensee conducts and documents emergency drills. The most recent drill was held on 8/20/19. There is a working carbon monoxide and smoke detector in the home. Licensee has met immunization requirement per SB 792. Licensee's CPR/First Aid certification expires on 2/4/21. Facility roster and a sample of children's records were reviewed and found to be complete. Licensee completed Mandated Reporter Training per AB1207 on 2/28/18. 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: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

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: ECKMAN FAMILY CHILD CARE	FACILITY NUMBER: 406215627
	VISIT DATE: 10/22/2019

NARRATIVE

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Licensee is not providing Incidental Medical Services (IMS). 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: http://www.ada.gov/childqanda.htm.

LPA reviewed and provided Licensee with Safe to Sleep brochure. Licensee distributes “Effects of Lead Exposure” 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.

Fire clearance for a large family child care home was received on 8/15/19. Effective today, 10/22/19, Licensee is granted a capacity increase from a small family child care home to a large family child care home. LPA reviewed capacity requirements and Assistant requirements with Licensee.

No deficiencies cited today.

LPA observed Notice of Site Visit posted.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2019

LIC809 (FAS) - (06/04)

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