406215627-8-26-2021-17-CC-MKST-C69UPR-20210826154558

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406215627
Report Date: 08/26/2021
Date Signed: 08/26/2021 03:46:04 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:	ECKMAN FAMILY CHILD CARE		FACILITY NUMBER:	406215627
ADMINISTRATOR:	KATIE MAE ECKMAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 264-5687
CITY:	PASO ROBLES	STATE: CA	ZIP CODE:	93446
CAPACITY:	14	CENSUS: 1	DATE:	08/26/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Katie Eckman		TIME COMPLETED:	03:50 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 8/26/2021 at 2:50pm, Licensing Program Analyst (LPA) Melissa Stewart conducted a Facility Risk Assessment for COVID19 with Licensee, Katie Eckman. All answers indicated no exposure to COVID19. The purpose of the visit, Required 1 year inspection, was explained. LPA observed the required documents posted inside of the home on the wall adjacent to the front door. Licensee had just returned from picking her school aged child up and reported that the other children had been picked up by parents earlier that day. Licensee has face masks for children and adults. LPA provided the updated CDPH Guidance which states that children over the age of 2 years should be taught and encouraged to wear face coverings while indoors. Child care services are provided in the the living room and dining room. LPA observed three (3) portable cribs, age appropriate toys, books and child sized tables and chairs. There is fireplace in the living room with a glass screen secured with a zip tie and a safety gate which is makes the fireplace inaccessible. There is a large screen tv with heavy base in front of the fireplace. In the hallway, there is a safety gate which leads to the bathroom used by children and three (3) bedrooms with safety gates and door knob locks on each door making the bedrooms inaccessible to children in care. The bathroom used by children was observed to be clean and free of toxins. Licensee stated there are no guns or ammunition in the home. Detergents, cleaning compounds, medications and other items such as kitchen knives which could pose a danger to children are stored inaccessible to children. Smoke and Carbon monoxide detectors were tested at 2:52pm and found to be operational. LPA observed the 2 A10 BC fire extinguisher with a service date of 6/14/2021. Licensee was reminded to service or replace the fire extinguisher yearly. Licensee completes and documents emergency drills. The most recent drill was held on 8/5/21. 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: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

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: 08/26/2021

NARRATIVE

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LPA observed the outdoor activity area which is accessed through the sliding glass door in the dining room. There is a covered patio and a variety of toys, climbers with slides and play houses located on grass. Licensee has two (2) mediums sized dogs in a fenced and locked area on the side of the home. There is also a trampoline and other toys only used by Licensee's child in this area. Licensee has current Pediatric CPR and first aid expiring on 2/4/2023. Licensee has met SB 792 immunization requirement and completed Mandated Reporter Training per AB 1207 on 8/25/2021. Facility roster and a sample of children's records were reviewed and found complete.

Infant Safe Sleep Regulation section 102425 was discussed. LPA provided PIN 20-24-CCP, Individual Infant Sleep Plan (LIC9227) and a sample Infant Sleep Log for 15 minute checks of all children under the age of two (2) years. Licensee reported that the “Effects of Lead Exposure” brochure is distributed to all families at time of enrollment. LPA advised Licensee that Title 22, Division 12 regulations for Family Child Care Homes and California Department of Public Health COVID-19 guidelines for child care programs can be accessed on-line at www.cdss.ca.gov. Licensee stated that she is subscribed to receive Provider Information Notices (PINs) from Community Care Licensing Division via email.

Incidental Medical Services (IMS) policy was discussed. Licensee stated that there are no children enrolled who require medications at this time. 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

In the areas evaluated today, no deficiencies were cited.

A copy of this report and appeal rights were discussed and left with Licensee, Katie Eckman, whose signature on this form confirm receipt of these documents.

LPA provided a Notice of Site Visit (LIC 9213) to be posted. FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K Stewart	TELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:	DATE: 08/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2021

LIC809 (FAS) - (06/04)

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