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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426214281
Report Date: 10/26/2022
Date Signed: 10/26/2022 02:39:47 PM


Document Has Been Signed on 10/26/2022 02:39 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:LESVENAN FCC AKA CADENCE FOR KIDSFACILITY NUMBER:
426214281
ADMINISTRATOR:MARYVONNE LESVENANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 448-3684
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:14CENSUS: 5DATE:
10/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:45 PM
MET WITH:Maryvonne LesvenanTIME COMPLETED:
02:40 PM
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On October 26, 2022 at 12:45 PM Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Licensee, Maryvonne Lesvenan, LPA asked Covid-19 pre screening questions, licensee's responses indicate there are no COVID-19 exposure on site. Licensee provided LPA a tour of the facility inside and out. There were 5 children present during the inspection 3 of whom are infants.

This is 2 story home with 2 bedrooms and 2 1/2 baths. Family Child Care Home (FCCH) uses living room, kitchen, dining, toilet room and the gated front yard and back yard. The 2nd floor has a baby gate at the bottom of the stair case making it inaccessible to day care children, LPA observed age appropriate toys, books and furnishings in the indoor activity area. LPA observed pack n play in the day care room. All hazardous items are stored inaccessible to children in care. The backyard is enclosed with a 3 foot wooden fence. Licensee physically and visually supervise children at the backyard. LPA observed age appropriate play equipment and toys in the front yard. Licensee stated there are no guns nor ammunition in the home. Fire extinguisher was serviced on 7/15/2022. Smoke and carbon monoxide detectors were observed.

LPA reviewed facility file, licensee has current Pediatric First Aid and CPR which expires, 10/16/2023. Licensee's Mandated Reporter Training expires on 6/20/2024. Licensee has proof of immunization per SB 792 against pertussis, and measles. FCCH conducts fire and disaster drill every 6 months, last drill was conducted on 7/14/2022. Children's roster is current. LPA reviewed children records, Emergency and Identification card on file. Infant Safe Sleep Plan (LIC9227) for Infants 0 to 12 months are completed and signed by authorized representative and licensee, licensee checks and documents napping infants every 15 minutes.

CONTINUED on LIC 809C

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:
DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/26/2022
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: LESVENAN FCC AKA CADENCE FOR KIDS
FACILITY NUMBER: 426214281
VISIT DATE: 10/26/2022
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The FCCH does not provide Incidental Medical Services (IMS). 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: http://www.ada.gov/childqanda.htm

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

LPA 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. LPA 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 or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

During today's inspection, Family Child Care Home is in compliance of Title 22 Division 12.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee, Maryvonne Lesvenan
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi ReyesTELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022
LIC809 (FAS) - (06/04)
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