<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426204072
Report Date: 07/12/2019
Date Signed: 07/12/2019 10:29:24 AM

COMPREHENSIVE INSPECTION
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:FIERCE-SHERMAN FAMILY CHILD CAREFACILITY NUMBER:
426204072
ADMINISTRATOR:FIERCE, JULIE/LEGALFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 740-1297
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 3DATE:
07/12/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Julie Fierce-ShermanTIME COMPLETED:
10:40 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
A required annual inspection was conducted by Licensing Program Analysts (LPAs) S. Mendoza-Ceja and E. Baddley who met with Licensee Fierce-Sherman. The home was toured inside and outside. The home was observed to be clean and orderly. Today, Licensee was providing care to three children. Licensee stated the area where the play structure is not be used by the day care children and was observed to be fenced and inaccessible to day care children. Licensee stated there are no firearms/ammunition or bodies of water on the premises. There is an operating dual smoke/carbon monoxide detector which was tested. There is a 2 A10 BC Fire Extinguisher tag is dated 05/24/2018. Licensee was advised the fire extinguisher needs to be serviced yearly. The last emergency fire drill was conducted on 06/03/2019. The appropriate documents were posted for review. LPA reviewed children's records, including the child care roster. The handouts "A Child Care Provider's Guide to Safe Sleep, Safe Sleep in Child Care and the Effects of Lead Exposure " were reviewed with licensee. LPA reviewed current CPR and First Aid for Licensee (expires 04/22/2020). Licensee was reminded the requirement for care providers/employees and volunteers to obtain immunization against Influenza, Pertussis, and Measles. LPA discussed the requirement for AB1207 Child Abuse Mandated Reporter Training. Licensee stated she had not completed the AB 1207 Child Abuse Mandated Reporter Training. Licensee was advised failure to complete the training has resulted in a Repeat Violation and immediate civil penalty of $250.00 is assessed.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
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 3
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: FIERCE-SHERMAN FAMILY CHILD CARE
FACILITY NUMBER: 426204072
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/15/2019
Section Cited
CCR
1596.886(b)(1)
1
2
3
4
5
6
7
Health and Safety: Child Abuse Mandated Reporter Health and Safety - Child Abuse Mandated Reporter Training: On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following
1
2
3
4
5
6
7
Please submit verificaiton to Licensing for review.
8
9
10
11
12
13
14
the date on which he or she completed the initial mandated reporter training. --This requirement was not met as evidenced by the record review and interview which revealed licensee has not completed the training which poses a potential health and safety risk to children in care. Repeat Violaiton Immediate Civil Penalty Assessed $250.00.
8
9
10
11
12
13
14
Type B
07/15/2019
Section Cited
CCR
102417(g)(1)
1
2
3
4
5
6
7
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: ... The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal.
1
2
3
4
5
6
7
During the visit, Licensee scheduled the fire extinguisher for service.

Licensee shall submit verification to the Department for review.
8
9
10
11
12
13
14
This requirement was not met as evidenced by the record review which revealed licensee failed to service or replaced the 2 A10 BC Fire Extinguisher dated 05/24/2018 which poses a potential health and safety risk to children in care
8
9
10
11
12
13
14
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: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: FIERCE-SHERMAN FAMILY CHILD CARE
FACILITY NUMBER: 426204072
VISIT DATE: 07/12/2019
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
26
27
28
29
30
31
32
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes 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

The following Type B deficiencies are cited according to CCR, Title 22, Division 12 in regards to Child Abuse Mandated Reporter Training and the Fire Extinguisher. Appeal Rights provided.

LPAs observed the Notice of Site Visit posted.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3