426215700-1-4-2022-17-CC-DTHN-CACNTT-20220104094516

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215700
Report Date: 01/04/2022
Date Signed: 01/04/2022 09:45:25 AM

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:	BARTHOLIC FAMILY CHILD CARE		FACILITY NUMBER:	426215700
ADMINISTRATOR:	NEOSHA L BARTHOLIC		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 684-3126
CITY:	CARPINTERIA	STATE: CA	ZIP CODE:	93013
CAPACITY:	14	CENSUS: 2	DATE:	01/04/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:24 AM
MET WITH:	NEOSHA BARTHOLIC		TIME COMPLETED:	10:04 AM

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 January 4, 2022 at 8:36 AM, Licensing Program Analysts (LPA) Dean Thompson conducted an unannounced Annual/Random inspection. LPA conducted the Covid-19 screening questions prior to entering the facility. LPA met with licensees Neosha Bartholic and advised the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. Licensee stated she uses the back as the entrance for visitors and day care children. There were two children in care at the time of the inspection. LPA observed required licensing documents mounted on the wall near the entrance of the day-care. Children in care have access to the family room, restroom, and backyard. During the tour, LPA did not observe any hazards/toxins accessible to children in care. Licensee stated there are no firearms or ammunition inside the home. There are no bodies of water present at the time of inspection. Fire and carbon monoxide alarms were viewed. Fire extinguisher 2A10BC is fully charged with a service date of 3/18/21. Fire and earthquake drills are being logged. Last drill conducted on 12/8/21. Children have access to toys that are age-appropriate inside and outside of the home. Back yard is enclosed and shaded. LPA reviewed children files. Licensee advised there were no children in care that required Incidental Medical Services. Licensee mandated reporter training viewed. Licensee CPR/first aid is valid through 2/15/2022. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2022

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: BARTHOLIC FAMILY CHILD CARE	FACILITY NUMBER: 426215700
	VISIT DATE: 01/04/2022

NARRATIVE

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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.

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 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.

www.mandatedreporterca.com

Form LIC 9227 was handed to the licensee Neosha Bartholic

No deficiencies were cited during today's inspection.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with licensee Neosha Bartholic

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2022

LIC809 (FAS) - (06/04)

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