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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421711544
Report Date: 06/12/2023
Date Signed: 06/12/2023 05:33:12 PM

Document Has Been Signed on 06/12/2023 05:33 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:SHAPIRO FCC AKA TECOLOTE FAMILY CHILD CAREFACILITY NUMBER:
421711544
ADMINISTRATOR:SHAPIRO, LYNNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 688-2001
CITY:LOS OLIVOSSTATE: CAZIP CODE:
93441
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
06/12/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:30 PM
MET WITH:Lynn ShapiroTIME COMPLETED:
05:45 PM
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On 6/12/23, at 3:30 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Lynn Shapiro, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. The FCCH's playroom, playroom bathroom and backyard are used for child care, while the remainder of the home is excluded from child care. At the time of the inspection LPA observed seven children in care along with one Assistant (cleared and associated).

The FCCH is void of hazardous items and the bathroom the children use for care is clean and free of toxins. Medication, cleaning compounds and sharps are stored in location which are inaccessible to children in care. Toys, furniture and equipment observed are age appropriate. Required licensing forms and documents are posted on the wall of the FCCH near the entry. The FCCH has a fireplace which is screened by glass and inaccessible to children. LPA observed a smoke and carbon monoxide detector in the FCCH. The detectors were tested at 3:37 PM and found to be operable. LPA observed a regulation fire extinguisher in the FCCH which was last serviced on 9/2/22. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually.

The backyard is enclosed by a wooden fencing and the footing in the area is varied. The fence’s entry/exit gates are secure. Toys and play equipment viewed on site vary by age. LPA reminded Licensee to ensure children are using equipment and play structure which are age appropriate. There are three sheds in the back yard which are all secured. The sheds contain household items. No bodies of water are observed on site.

A sampling of the children's records were reviewed. The records are current, complete and possessed emergency contact information, immunization records and documentation noting the children's sleep checks
(CONT. 809-C, Page 2).
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/12/2023
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: SHAPIRO FCC AKA TECOLOTE FAMILY CHILD CARE
FACILITY NUMBER: 421711544
VISIT DATE: 06/12/2023
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15 minute intervals, amongst other licensing required documents. The Licensee's records were also reviewed and found to be current. Pediatric CPR and First (EMSA approved) certifications expires 3/18/25 and Mandated Reporter certificate expire on 2/3/24. The last fire drill at the CCC occurred on 3/21/23. Licensee stated no firearm or ammunition is stored on site.

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

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.

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 for 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.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Lynn Shapiro.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 06/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023
LIC809 (FAS) - (06/04)
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