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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215860
Report Date: 10/28/2019
Date Signed: 10/28/2019 11:24:43 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:MILTIMORE FCC AKA LOVING LITTLEGFACILITY NUMBER:
426215860
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 1DATE:
10/28/2019
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Lisa MiltimoreTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA), Melissa Stewart, conducted an announced Pre-Licensing Inspection and met with applicant, Lisa Miltimore.

The home was toured inside and out. This is a two story home with a child proof gate at the top and bottom of the stairs. The kitchen, dining room and bathroom upstairs will be accessible to children during day care hours. The master bedroom with en suite bath is off limits and is made inaccessible by latches at the top of the doors. The fireplace was properly screened. The balcony is made inaccessible by a patio door pin. The upstairs and downstairs bathroom to be used by children were observed to be clean and free of toxins.
There are three rooms downstairs which will be used for child care. LPA observed clean, safe, age appropriate toys and pack n play cribs. All hazardous items are stored inaccessible to children in care. Licensee stated there are no guns or ammunition in the home. The backyard is completely fenced and has cement, grass and shade area. There are no bodies of water.

Applicants, Lisa and Ronald Miltimore, and assistant have met immunization requirement, have completed AB 1207 Mandated Reporter Training and are CPR/First Aid certified through 5/11/21. Applicants both completed the Preventative Health and Safety course 8/9/19. LPA observed the 2 A10 BC Fire Extinguisher which was serviced on 8/15/19. Applicant was reminded to service or replace the Fire Extinguisher yearly. The home is equipped with working smoke and carbon monoxide detectors. Continued on 809-C

SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: MILTIMORE FCC AKA LOVING LITTLEG
FACILITY NUMBER: 426215860
VISIT DATE: 10/28/2019
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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

LPA provided Pre-licensing packet to applicant, reviewed and issued to applicant updated samples of state required forms to be posted or retained in each child’s file. Applicant's liability insurance and mortgage documents were reviewed. LPA reviewed and provided applicant with a copy of “Child Care Providers Guide to Safe Sleep.” LPA provided “Effects of Lead Exposure” to be distributed to all families. Applicant was made aware that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.

The home meets all requirements of Title 22 Division 12 for a Small Family Child Care Home.

License is granted today, 10/28/19.
SUPERVISOR'S NAME: Maria MuellerTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Melissa K StewartTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2019
LIC809 (FAS) - (06/04)
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