426215013-5-31-2022-17-CC-EBAY-CEXSJM-20220531135522

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215013
Report Date: 05/31/2022
Date Signed: 05/31/2022 01:55:35 PM

Document Has Been Signed on 05/31/2022 01:55 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:	WARD FCC AKA LIL SAFARI CHILD CARE		FACILITY NUMBER:	426215013
ADMINISTRATOR:	ASHLEY WARD		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 354-3469
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93458
CAPACITY:	14	CENSUS: 9	DATE:	05/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Ashley Ward		TIME COMPLETED:	02:00 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 5/31/22, at 12:00 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced One Year Required Annual inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Ashley Ward, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of the Licensee toured the interior and exterior of the FCCH. The FCCH’s dining room, family room, guest bedroom, backyard and hallway bathroom are used for child care services, while the home’s upper story and garage are excluded from care. LPA observed a child safety gate at the base of the stairwell which prevents children's access to the upper level. At the time of the inspection, nine children are present along with 3 Assistants. The home is orderly and the bathroom used for child care is clean and free of toxins. LPA observed medication and sharps in the FCCH stored on an elevated shelf in a kitchen cabinet. LPA also observed cleaning compounds stored in the FCCH's laundry room secured and inaccessible to child in care. Toys, furniture and equipment observed in the FCCH's interior are age appropriate. Required licensing forms and documents are posted at along the wall of FCCH. The FCCH’s family room has a fireplace which is barricade by a wooden shelving unit and inaccessible to children. The FCCH has a regulation fire extinguisher which was purchased on 5/31/22. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA observed a smoke and carbon monoxide detector in the FCCH which were tested at 12:30 PM and found to be operable. The backyard is enclosed by wooden fencing and cider block wall. The area has a secure shed which contains household furniture. Toys and play equipment observed in backyard are age appropriate. No bodies of water were observed on site. LPA reviewed children records. The records were current, complete and possessed emergency contact CONT. 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

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: WARD FCC AKA LIL SAFARI CHILD CARE	FACILITY NUMBER: 426215013
	VISIT DATE: 05/31/2022

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information. LPA observed documentation for children's sleep which included checks in intervals of 15 minutes. LPA reviewed the Licensee's and Assistant's records which are also current and complete. CPR and First Aid certifications for Licensee expire on 6/22, while Mandated Reporter Training expires on 4/26/23 . Licensee was reminded to ensure training certifications are renewed prior expirations. The Licensee stated no firearms or ammunition are stored on site.

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: http://www.ada.gov/childqanda.htm

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.

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

for additional resource. LPA also informed Licensee Ashley Ward 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.

A Notice of Site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Ashley Ward.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Elvin Baddley	TELEPHONE: (805) 635-4697
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

LIC809 (FAS) - (06/04)

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