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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426213340
Report Date: 12/26/2019
Date Signed: 12/26/2019 12:06:31 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:DE LEON FCC AKA LITTLE HANDS FAMILY DAY CAREFACILITY NUMBER:
426213340
ADMINISTRATOR:EDITH DE LEONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 720-1134
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 11DATE:
12/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:04 AM
MET WITH:Edith deLeonTIME COMPLETED:
11:10 AM
NARRATIVE
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(1)Licensing Program Analyst (LPA), Melissa Stewart, conducted an unannounced annual/random inspection and met with Licensee, Edith DeLeon. The purpose of the inspection was explained and the home was toured inside and out. All required forms are posted in a prominent location. At the time of inspection, there were 11 children (including two infants) supervised by two assistants and licensee.

The family child care home operates on the first floor and backyard of the home. LPA observed age appropriate toys, books and furnishings in the indoor activity area which is accessed through the outdoor activity area. The bathroom used by children was observed to be clean and free of toxins. There are three emergency evacuation cribs for napping infants. The upstairs is off limits and is made inaccessible by a child safety gate. All hazardous items are stored inaccessible to children in care. Licensee stated there are no guns or ammunition in the home. Outdoors, LPA observed playhouse, small climbing structures located on turf, child sized tables and shaded areas. The backyard is completely fenced; there are no bodies of water.
Carbon monoxide and smoke detectors were tested and operational. LPA observed two fire extinguishers (one in the kitchen and one in the indoor activity room) which were serviced on 5/2/19. Licensee was reminded to service or replace the fire extinguishers yearly. Licensee completes and documents emergency drills. The most recent drill was held on 10/29/19. Licensee and assistants are Pediatric CPR and first aid certified through 2021. Licensee and one assistant has met SB 792 immunization requirement. Cont. on 809-C
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2019
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: DE LEON FCC AKA LITTLE HANDS FAMILY DAY CARE
FACILITY NUMBER: 426213340
VISIT DATE: 12/26/2019
NARRATIVE
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 Facility roster and a sample of children's records were reviewed and found complete.

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: www.ada.gov/childqanda.htm

LPA reviewed and provided Licensee with Safe to Sleep brochure. LPA provided “Effects of Lead Exposure” brochure to be distributed to all families. 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) which can be accessed on-line at www.ccld.ca.gov.

See LIC 809-D for cited deficiencies in accordance with the California Code Regulations Title 22, Division 12 and/or Health and Safety Code. Appeal rights provided.


An exit interview was conducted and Plans of Corrections were reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and left with Licensee, Edith DeLeon, whose signature on this form confirm receipt of these documents.

LPA observed Licensee post the Notice of Site visit.

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2019
LIC809 (FAS) - (06/04)
Page: 3 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: DE LEON FCC AKA LITTLE HANDS FAMILY DAY CARE
FACILITY NUMBER: 426213340
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/26/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/24/2020
Section Cited

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Immunization Requirement- a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. ....The day care center shall maintain documentation of the required immunizations... in the person’s personnel record....
This requirement is not met as evidenced by:
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Based on interviews conducted, Licensee failed to ensure that she had proof of measels immunization for S3 on file at the day care. S3 stated that she though she had received the MMR vaccination at the same time as the Tdap vaccination, however upon review of documentation, no record of MMR was found.
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This poses a potential health and safety risk to 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: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:
DATE: 12/26/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/26/2019
LIC809 (FAS) - (06/04)
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