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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421712407
Report Date: 08/08/2023
Date Signed: 08/08/2023 03:35:01 PM


Document Has Been Signed on 08/08/2023 03:35 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:CARPENTER FAMILY CHILD CAREFACILITY NUMBER:
421712407
ADMINISTRATOR:CARPENTER, JULIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 733-2204
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 21DATE:
08/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Julia CarpenterTIME COMPLETED:
03:55 PM
NARRATIVE
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On 8/8/2023, at 12:00 PM, Licensing Program Analysts (LPAs) Martina Jimenez and German Negrete, conducted an unannounced Required Annual Inspection. LPAs met with Licensee of the Julia Carpenter, licensee, Ashleigh Taubman, assistant, Alyssa Barraza, assistant, and Kirstin Pinkerton, assistant. The purpose of the inspection was discussed with the Licensee and together we toured the inside and outside of the home. LPAs observed three (3) infants and eighteen (18) children in care at the time of the inspection.

The main day care areas are the downstairs garage conversation day-care room, and bathroom. LPAs observed the stairs leading upstairs to the living room, kitchen, dining room, three (3) bedrooms and hallway bathroom accessible to children in care. LPAs observed in the kitchen prescription medications, vitamins, and scissors, accessible to children in care. LPAs observed on the second floor in bedroom#2, C2 asleep with the bedroom door closed at the time of the inspection. LPAs observed in bedroom#3, C19 asleep with the bedroom door closed at the time of the inspection.

LPAs observed the day care area to be clean and orderly. LPAs observed age appropriate books, toy, games, tables and chairs. LPAs observed the off-limits area which include bedroom#,1 secured with locks on the doors. The backyard is completely fenced. LPAs observed a baby walker in the children's play area. No bodies of water were observed.

Licensee stated that there are no weapons/ammunition in the home. Licensee stated she does not hold a foster family license. The facility roster was not available for review at the time of the inspection. The review of children's file revealed that C1, C2, C12, 14, C15, C16, C17, C18, C20, and C21, did not have file available for review at the time of inspection. LPAs observed files for C2, C19 & C20, did not have safe sleep charts at the time of the inspection.

THIS REPORT CONTINUES ON LIC 809C & LIC 809D
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2023
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: CARPENTER FAMILY CHILD CARE
FACILITY NUMBER: 421712407
VISIT DATE: 08/08/2023
NARRATIVE
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The fire extinguisher was observed and was serviced April 21, 2023. Per the licensee here is a functioning carbon monoxide detector and smoke alarm that were tested on July 20, 2023. The children were napping at the time of the inspection. Licensee and assistants are current with immunization required per SB 792. The last Safety drill was conducted on July 20, 2023. Licensee is current with CPR and First Aid which expires February 4, 2025. Licensee and assistants completed the Mandated Reporter Training required per AB 1207, on June 29, 2022.

Licensee is not providing Incidental Medical Services. 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: htttp://www.ada.gov/childqanda.htm

LPA reviewed with Licensee the Safe Sleep Regulation. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided on line at www.ccld.ca.gov. Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home and was advised to review Quarterly Updates and Provider Information Notices (PINs), Title 22 & Health & Safety Codes which can be accessed on-line athttps://www.cdss.ca.gov/inforesources/child-care-licensing

Today, deficiency cited under Title 22 Division 12 Appeal rights given.


Upon receipt of this report, licensee shall post and provide copies of this licensing report to parents /guardian of children in care at the facility and to parent/guardians of children newly enrolled at the facility during the next 12 months. Licensee to provide LIC 9224 for each child in care and have each parent sign the form that they have received a copy of the report LIC 809 and LIC 809 D.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:

DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 08/08/2023 03:35 PM - It Cannot Be Edited

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: 08/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(3)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (3) Where children are less than five years old are in care, stairs shall be fenced or barricaded.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observation the stairs leading upstairs to the living room, kitchen, dining room, three (3) bedrooms and hallway bathroom were accessible to children in care at the time of the inspection, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/09/2023
Plan of Correction
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Licensee will submit in writing how licensee will prevent future incidents from occurring, along with photos of corrections to CCLD by 8/9/23, via email: Martina.Jimenez@dss.ca.gov
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observed in the kitchen prescription medications, vitamins, and scissors, accessible to children in care, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/09/2023
Plan of Correction
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Licensee will submit in writing how licensee will prevent future incidents from occurring to CCLD, along with photos of corrections by 8/9/23, via email: Martina.Jimenez@dss.ca.gov
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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2023
LIC809 (FAS) - (06/04)
Page: 3 of 6


Document Has Been Signed on 08/08/2023 03:35 PM - It Cannot Be Edited

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: 08/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102425(j)(6)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall be on the same floor as the sleeping infant.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observed on the second floor in bedroom#2, C2 asleep with the bedroom door closed at the time of the inspection. LPAs observed in bedroom#3, C19 asleep with the bedroom door closed at the time of the inspection, which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 08/09/2023
Plan of Correction
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Licensee will submit a written statement on how licensee will prevent future incidents from occurring to CCLD by 8/9/23, via email: Martina.Jimenez@dss.ca.gov
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2023
LIC809 (FAS) - (06/04)
Page: 4 of 6


Document Has Been Signed on 08/08/2023 03:35 PM - It Cannot Be Edited

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: 08/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(10)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (10) A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Sections 1596.846(b) and (c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observed a baby walker in the children's play area, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2023
Plan of Correction
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Licensee removed the baby walker during the inspection.
Type B
Section Cited
CCR
102425(j)(2)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall check and document the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observed files for C2, C19 & C20, did not have safe sleep charts at the time of the inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2023
Plan of Correction
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Licensee will submit photos of completed safe sleep chart to CCLD by 8/15/23, via email: Martina.Jimenez@dss.ca.gov
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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2023
LIC809 (FAS) - (06/04)
Page: 5 of 6


Document Has Been Signed on 08/08/2023 03:35 PM - It Cannot Be Edited

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: 08/08/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102425(j)(4)
Infant Safe Sleep
The provider shall supervise infants while they are sleeping and adhere to the following requirements: The provider shall be near enough to the sleeping infant to be able to hear them wake up.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs observed on the second floor in bedroom#2, C2 asleep with the bedroom door closed at the time of the inspection. LPAs observed in bedroom#3, C19 asleep with the bedroom door closed at the time of the inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2023
Plan of Correction
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2
3
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Licensee will submit a written statement on how licensee will prevent future incidents from occurring to CCLD by 8/15/23, via email: Martina.Jimenez@dss.ca.gov
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the facility roster was not available for review at the time of the inspection, which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/15/2023
Plan of Correction
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Licensee will submit a written statement on how licensee will prevent future incidents from occurring to CCLD. Licensee will submit a current and complete roster by 8/15/23, via email: Martina.Jimenez@dss.ca.gov
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: Martina JimenezTELEPHONE: (805) 387-5041
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2023
LIC809 (FAS) - (06/04)
Page: 6 of 6