426208638-8-12-2024-17-CC-EBAY-D83TJY-20240812144706

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426208638
Report Date: 08/12/2024
Date Signed: 08/12/2024 02:47:55 PM

Document Has Been Signed on 08/12/2024 02:47 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:	HOLFORD FAMILY CHILD CARE		FACILITY NUMBER:	426208638
ADMINISTRATOR:	BLANCHE HOLFORD		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 868-0574
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY:	14	CENSUS: 5	DATE:	08/12/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Blanche Holford		TIME COMPLETED:	03:00 PM

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	On 8/12/24, at 12:45 PM, Licensing Program Analyst (LPAs) Elvin Baddley and Matthew Sapien conducted an unannounced Annual/Random Inspection of the abovementioned Family Child Care Home (FCCH). LPAs met with Blanche Holford, Licensee of the FCCH and explained the nature and purpose of the inspection. LPAs, in the company of Licensee toured the interior and exterior of the FCCH. The FCCH’s great room, family room, guest bedroom, backyard and hallway restroom are used for child care services, while the remaining bedrooms are excluded from child care. At the time of the inspection, five children are present along with one Assistant (cleared and associated) providing care and supervision. It should be noted all children in care are in different phases of sleep during the time of the inspection. The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. Medication and cleaning compounds in the FCCH are stored in elevated cabinets in the kitchen. Medication in the FCCH is also stored in bathroom's medicine cabinet which is secured. Both areas where medication is stored are inaccessible to children in care. Toys, furniture and equipment in the FCCH are age appropriate. LPAs observed licensing required forms and documents posted on the wall of FCCH near the entry door. The FCCH’s living room has a fireplace in the living room which is covered by glass. The FCCH's restroom used for child care is observed to be clean and free of toxins. LPAs observed smoke and carbon monoxide detectors throughout the FCCH. The aforementioned were not tested as children in care are sleeping. Licensee informed LPAs the smoke and carbon monoxide detector batteries were changed in April of 2024 to coincide with Daylight Saving. The FCCH has a regulation fire extinguisher on site which was service on 10/10/23. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services. The backyard is enclosed by wooden fencing. The fence’s entry/exit gate is secure. Toys and play equipment (CONT. 809-C, Page 2)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024

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: HOLFORD FAMILY CHILD CARE	FACILITY NUMBER: 426208638
	VISIT DATE: 08/12/2024

NARRATIVE

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observed in backyard are age appropriate and in satisfactory condition. Licensee is reminded to replace toys and equipment which start to degrade. LPAs also observed a shed in the area which is secure and contains household goods. LPAs observed no bodies of water on site.

LPAs reviewed a sample children's records. The records are current, complete and possessed emergency contact information, children's immunization records and sleep checks logs, among other required licensing forms and documents. The Licensee's records are also current and complete with pediatric CPR and First Aid certifications (EMSA approved) expiring on 3/9/26. The Licensee's Mandated Reporter training certification expires on 2/13/25 . Licensee is reminded to renew certifications and training prior to expirations. A review of the FCCH's fire drill log show drills are current with the last occurring on 8/7/24. The Licensee informed LPAs no firearms or ammunition are stored on site.

The Licensee does not provide Incidental Medical Services (IMS). IMS policy was discussed. For IMS information see PIN 22-02CCP. 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) or (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.

LPAs 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 an additional resource. LPAs 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.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5-days or, if the penalty is for a
(CONT.809-C, Page 3)

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024

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: HOLFORD FAMILY CHILD CARE	FACILITY NUMBER: 426208638
	VISIT DATE: 08/12/2024

NARRATIVE

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repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 8/12/24.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee Blanche Holford.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 08/12/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2024

LIC809 (FAS) - (06/04)

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