426215738-4-19-2022-17-CC-FVEZ-CDMR3Y-20220419124043

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215738
Report Date: 04/19/2022
Date Signed: 04/19/2022 12:40:52 PM

Document Has Been Signed on 04/19/2022 12:40 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:	TELL FCC AKA AVID ANGELS DAY CARE		FACILITY NUMBER:	426215738
ADMINISTRATOR:	KIANA NICOLE TELL		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 478-9869
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93454
CAPACITY:	14	CENSUS: 9	DATE:	04/19/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	KIANA NICOLE TELL		TIME COMPLETED:	01:00 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 4/19/22, at 10:00 AM Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Kiana Nicole Tell, Licensee of the FCCH and explained the nature and purpose of the inspection. LPA notes nine (9) children are on site along with Assistant, Victoria Leon. LPA, in the company of the Licensee, toured the exterior and interior of the FCCH. The home’s day-care room, bathroom right next to the day-care room, one (1) bedroom and outdoor yard are used for child care services, while two (2) bedrooms, one (1) bathroom and garage are excluded from services. Licensee also does not use, living room, dining room and kitchen, however, children are escorted through these areas by Licensee or Assistant to get to the day-care room. LPA notes that off limit bedroom doors and bathroom were closed and have an additional safety lock on the door handles. LPA notes that small gate is placed right by the day-care room, making kitchen, dining room, and bedrooms inaccessible to children in care. The restroom used by children was observed to be clean with plenty of hand soap and paper towels. LPA notes that inside the restroom, Licensee has washing machine and dryer as well. LPA notes that cleaning compounds are located in an elevated cabinet in the restroom, inaccessible to children in care. LPA also notes that both washing machine and drying machine have additional safety latches, making them inaccessible to children in care. The FCCH is orderly and has ventilation to afford for the children’s comfort and safety. Medication in the FCCH is stored in an elevated cabinet in the kitchen. Sharps are stored in an elevated shelf in the pantry located in the kitchen. Cleaning compounds were observed to be stored in an elevated shelve in the panty, in the garage, in an elevated cabinet in the children restroom and on top of the refrigerator in the kitchen. LPA observed that all areas are inaccessible to children in care. Toys, furniture and equipment observed in the FCCH are age appropriate. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

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: TELL FCC AKA AVID ANGELS DAY CARE	FACILITY NUMBER: 426215738
	VISIT DATE: 04/19/2022

NARRATIVE

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Required forms are posted on the day-care room wall. The FCCH has combination smoke and carbon monoxide detector which were tested at 10:19 am and found to be operable. The FCCH has a regulation fire extinguisher which was serviced 4/11/22. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill documentation. The last drill was completed on 2/11/22.

The outdoor play yard is completed fenced. LPA notes that the side yards are made inaccessible by fences. LPA observed one (1) shed that is located in an outdoor area that is inaccessible to children in care. Toys, furniture and equipment observed in the yard are age appropriate. There is plenty of shade to offered the children. LPA observed that drinking water is available by means of individual cups. LPA observed no bodies of water on site.

A sampling of the children's records were reviewed. The records are current, complete and possessed emergency contact information. The Licensee's records were also reviewed and found to be complete. Licensee’s Pediatric CPR and First (EMSA approved) was taken 11/18/21 and Mandated Reporter Training Certificate was taken 2/7/22. LPA reviewed Assistant records and found them to be current and complete. Assistant's Pediatric CPR and First (EMSA approved) was taken 3/20/22 and Mandated Reporter Training Certificate was taken 1/12/22.

The Licensee notes 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. CONT 809-C

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: TELL FCC AKA AVID ANGELS DAY CARE	FACILITY NUMBER: 426215738
	VISIT DATE: 04/19/2022

NARRATIVE

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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 [facility representative] 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 and report was reviewed with the licensee, Kiana Nicole Tell.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisca Velazquez	TELEPHONE: (805) 883-8244
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2022

LIC809 (FAS) - (06/04)

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