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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426204072
Report Date: 11/15/2022
Date Signed: 11/15/2022 03:32:33 PM


COMPREHENSIVE INSPECTION

Document Has Been Signed on 11/15/2022 03:32 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:FIERCE-SHERMAN FAMILY CHILD CAREFACILITY NUMBER:
426204072
ADMINISTRATOR:FIERCE, JULIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 737-1178
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 4DATE:
11/15/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:57 PM
MET WITH:Julie FierceTIME COMPLETED:
03:45 PM
NARRATIVE
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On November 15th, 2022 @ 12:57PM Licensing Program Analyst (LPA) Rosie Breault an unannounced Required/Annual inspection. LPA met with Licensee Julie Fierce-Sherman. A Covid-19 prescreening was assessed and no exposure on site. LPA washed hands and participated in temperature check per licensee. LPA, along with director, toured the Family Child Care Home (FCCH). At the time of the inspection there were 4 children and licensee. Licensee husband was present, and fingerprint cleared. FCCH operates from 7:00AM-5:00PM Monday – Friday.

LPA observed age appropriate toys and furnishings, orderly and with proper ventilation. A working smoke /carbon monoxide detector was tested by licensee at 1:12PM and found to be in compliance. Combustibles, cleaning compounds, sharps, tools, medicines, and poisons are inaccessible and out of children’s reach. First aid kits are available and out of children’s reach. LPA observed bathroom to be clean and orderly.

Upon arrival, LPA observed licensee providing care to four (4) children who were napping during the inspection. One child was placed in a crib covered with a blanket to limit light access. This is a violation of Title 22 Division 12 102425 (b) (3) and a citation has been issued. LPA observed child to be covered in a blanket. Per Title 22 Division 12 102425 (b) (1) and a citation has been issued. The required fire extinguisher 2A10BC serviced on 06/14/2022. The outdoor play area has perimeter fencing, age appropriate toys, and ample shade. No bodies of water are present. Licensee Julie Fierce-Sherman stated there are no guns and ammunition in the home. Licensee Julie Fierce-Sherman has current Adult, Child, and Infant CPR and First Aid which expires 05/14/2024 Licensee completed AB1207 Child Abuse Mandated Reporter Training which expires 6/29/2023.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
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: FIERCE-SHERMAN FAMILY CHILD CARE
FACILITY NUMBER: 426204072
VISIT DATE: 11/15/2022
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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

Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. LPA reviewed SB 792 (Child Care Employee and Volunteer: Immunization and Tuberculosis Requirements) with Licensee. Licensee and assistant are compliant.

Based on Title 22 Division 12 deficiencies, two (2) Type B violations have been cited and appeal rights provided to licensee.

An exit interview was conducted with the licensee, and copy of report provided.

The Notice of Site Visit shall be posted for 30 days.

SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 2 of 3
Document Has Been Signed on 11/15/2022 03:32 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: FIERCE-SHERMAN FAMILY CHILD CARE
FACILITY NUMBER: 426204072

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2022
Section Cited

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 Cribs or play yards shall be free from all loose articles and objects.
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This is evidenced by:
LPA observing blanket in crib with child.
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Type B
11/15/2022
Section Cited

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There shall be no objects hanging above or attached to the side of the crib.
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This is evidenced by:
LPA observed top of crib being covered by a blanket.
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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) 562-0347
LICENSING EVALUATOR NAME: Maryrose BreaultTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3