426215837-9-10-2019-17-CC-SMCA-BFW27Z-20190910170933

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426215837
Report Date: 09/10/2019
Date Signed: 09/10/2019 05:10:14 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:	HALE FAMILY CHILD CARE		FACILITY NUMBER:	426215837
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS:	DATE:	09/10/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Megan Hale		TIME COMPLETED:	05:20 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	Licensing Program Analysts (LPAs) S. Mendoza-Ceja and C. Patterson met with Megan Hale for the purpose of conducting a prelicensing inspection. Mrs. Hale stated the hours of operation will vary based upon need. The entire home was toured inside and outside. Mrs. Hale stated the living room, dining room, kitchen, playroom and bathroom will be used for day care children. The backyard was also inspected and is completely enclosed by a fence. Mrs. Hale stated there are no bodies of water, no firearms, nor ammunition in the home. The off limit areas include the 3 bedrooms and one bathroom. The backyard includes off limit dog run which is made inaccessible with a fence. Mrs. Hale states that she does not the manufacturers directions for the play structure at this time and will make the climbing wall, slide, and stairs of the structure inaccessible. LPAs did not observe any bodies of water. There is a 2 A10 BC Fire Extinguisher in the home. Applicant is reminded to service or purchase the fire extinguisher yearly. There is a carbon monoxide and smoke detector which were tested and found functional. Megan Hale has completed Preventative Health and Safety, including 1st Aid/CPR certificate (expires 07/20/21). The mortgage statement was reviewed for the home. LPAs reviewed children's record keeping requirements. Mrs. Hale states that she does not have liability insurance. LPAs informed applicant that she will need parents to sign a waiver for the liability insurance (applicant was provided form). LPAs reviewed and discussed the "Safe Sleep in Child Care, Child Care Provider's Guide to Safe Sleep, and Effects of Lead Exposure" handouts were provided to applicant.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja	TELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

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: HALE FAMILY CHILD CARE	FACILITY NUMBER: 426215837
	VISIT DATE: 09/10/2019

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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.

Prior to licensure the following will need to be completed:
1. Complete AB1207 Mandated Reporter Training
2. Replace or Service Fire Extinguisher
3. Make inaccessible the climbing areas and slide of the play structure

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Sylvia Mendoza-Ceja	TELEPHONE: (805) 722-5132
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2019

LIC809 (FAS) - (06/04)

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