566213945-4-7-2022-17-CC-DTHN-CD9UEY-20220407153156

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566213945
Report Date: 04/07/2022
Date Signed: 04/07/2022 03:32:01 PM

Document Has Been Signed on 04/07/2022 03:32 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:	KARP FAMILY CHILD CARE		FACILITY NUMBER:	566213945
ADMINISTRATOR:	DAWN KARP		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 312-3314
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	14	CENSUS:	DATE:	04/07/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Dawn Karp		TIME COMPLETED:	03:45 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 April 7, 2022 at 1:35 PM, Licensing Program Analysts (LPAs) Dean Thompson and Rona Chavez conducted an unannounced Annual/Random Inspection. LPA met with licensee Dawn Karp and informed the licensee the reason for the inspection. Covid pre-screening questions were asked to make sure no one inside the home has tested positive for covid or have any flu like symptoms. Licensee gave LPA a tour inside and outside of the home. During the time of inspection there were five children and one adult (licensee) providing care. LPA observed required documents posted inside the play area of the day care. Fire extinguisher 2A10BC has a purchase date of 9/21/2021. Licensee was reminded to document and conduct fire/earthquake drills every six months. Licensee CPR certification is current until 7/23/2022. Licensee mandated reporter certification expired 1/17/2020. LPA reminded licensee, all adults providing care are required to have the certification. Licensee advised there are no firearms or ammunition in the home. Fire place located in living room is covered with a metal screen. The home has a jacuzzi and pool in the back yard that children do not have access to. There were no toxins or hazardous material accessible to children in care. Children have access to two bedrooms, play room, and one restroom when in care. Children have access to toys that are age-appropriate inside and outside the home. Children's play area is located at the side entrance of the home. Parents use the outside area for pick up and drop offs. 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: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

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: KARP FAMILY CHILD CARE	FACILITY NUMBER: 566213945
	VISIT DATE: 04/07/2022

NARRATIVE

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During the inspection, LPAs reviewed children files to be current. Licensee advised there are children in care that require Incidental Medical Services. LPA explained to licensee that all medication should be inaccessible to children in care. Medication should have a zip lock bag with the child’s name on it or the medication itself. .All medication should not be expired.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or 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.

Licensee, was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

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 the licensee Dawn Karp.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Dean Thompson	TELEPHONE: (805) 729-8797
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022

LIC809 (FAS) - (06/04)

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