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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421712407
Report Date: 02/07/2020
Date Signed: 02/07/2020 01:00:54 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:CARPENTER FAMILY CHILD CAREFACILITY NUMBER:
421712407
ADMINISTRATOR:CARPENTER, JULIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 733-2204
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 13DATE:
02/07/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Analeah Torres and Gabrielle WilsonTIME COMPLETED:
12:40 PM
NARRATIVE
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A case management inspection was conducted by LPA S. Mendoza-Ceja who met with Licensee's two assistants who were providing care to 13 children which includes four infants (under the age of 2 years) and nine children (ages 2 - 5 years of age). Assistant #1 stated the licensee Carpenter had left to get lunch for the children and would be returning soon. Licensee arrived within 15 minutes. Licensee then contacted one of the parents to pick their child. Further review of the qualifications of assistant #2 revealed Gabrielle Wilson does not have a criminal record clearance with the Department. Licensee was advised failure to obtain a criminal record for Gabrielle Wilson prior to working the day care has resulted in an immediate civil penalty of $500.00. In addition, LPA observed the stairs leading upstairs was accessible to day care children. During the visit, LPA observed one of the children walk up the stairs unsupervised for lunch. LPA also observed no gate at the top of the stairs while children were eating lunch upstairs.

The following Type A deficiencies are cited according to CCR, Title 22, Division 12 in regards to capacity, criminal record clearance, and the stairs accessibility to day care children.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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: CARPENTER FAMILY CHILD CARE
FACILITY NUMBER: 421712407
VISIT DATE: 02/07/2020
NARRATIVE
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Notice of Site Visit has been posted (LIC9213). The notice shall be posted for 30 consecutive days. Failure to maintain posting as required will result in a $100.00 civil penalty. Copies of this report must be posted for 30 days in a visible location for authorized representatives of children.

Licensee shall 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.


Exit interview conducted with Licensee Carpenter and the plan of corrections were discussed. A copy of the Appeal Rights were given and explained.
Licensee's signature on this form acknowledges receipts of these rights.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020
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: CARPENTER FAMILY CHILD CARE
FACILITY NUMBER: 421712407
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2020
Section Cited

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Criminal Record Clearance: 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: Violation of Section 102370(d) will result in a citation of a deficiency and an immediate assessment of civil penalties of one hundred dollars ($100) per violation per day for a maximum of five (5) days by the Department.
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This requirement was not met as evidenced by LPAs observations and interviews which revealed Licensee allowed Gabrielle Wilson to work in the day care prior to obtaining a criminal record clearance with the Department. This poses an immediate risk to the health and safety of chidlren in care.
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Type A
02/07/2020
Section Cited

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Staffing Ratio and Capacity: The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. Twelve children, no more than four of whom may be infants;

This requirement was not met as evidenced by LPAs observations and
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 interviews which revealed Licensee accepted in her day care 13 children which includes four infants (under the age of 2 years) and nine children (ages 2 - 5 years of age). This poses an immediate risk to the health and safety of chidlren in care. During the visit, Licensee contacted one of the parents to pick up their child.
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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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2020
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: CARPENTER FAMILY CHILD CARE
FACILITY NUMBER: 421712407
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/07/2020
Section Cited

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Operation of a FCCH: The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: Where children less than five years old are in care, stairs shall be fenced or barricaded.

This requirement was not met as
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evidenced by LPA's observations and interviews which revealed the stairs leading upstairs was accessible to day care children. During the visit, LPA observed one of the children walk up the stairs unsupervised for lunch. LPA also observed no gate at the top of the stairs while children were eating lunch upstairs. 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: Ana TolentinoTELEPHONE: (805) 562-0437
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:
DATE: 02/07/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/07/2020
LIC809 (FAS) - (06/04)
Page: 4 of 4