<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566214138
Report Date: 02/11/2020
Date Signed: 02/11/2020 01:22:04 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:HUBBELL FCC AKA KELLIE'S KIDSFACILITY NUMBER:
566214138
ADMINISTRATOR:KELLIE HUBBELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 320-1059
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:14CENSUS: 2DATE:
02/11/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Kellie HubbellTIME COMPLETED:
01:35 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 Analyst, (LPA) Jill Laxo conducted an unannounced annual inspection at this large family child care facility and met with Licensee Kellie Hubbell. The purpose of the inspection was discussed and a tour of the home inside and out was conducted. During today's inspection the licensee had two children in care.

The facility is a two story home, the day care is primarily conducted in the day care room, family room and backyard. The second floor is off limits and gated at the stairs. Licensee has current liability insurance through State Farm. Cleaning products, medication and other items which could pose a danger are stored and inaccessible to children. There are no bodies of water on the property. Licensee states there are no firearms in the home. Fire extinguisher is a 2-A:10-B:C with a purchase date of 11/15/2019. The home has working smoke and carbon monoxide detectors. Licensee has all required forms posted for parents to view. An emergency drill was conducted on 11/27/2019. Safe toys and play equipment are provided for the children along with comfortable accommodations. Licensee has current roster of children in care. Children's files were reviewed and have required forms. Licensee has current CPR/First Aid with expiration date of 03/2020. Licensee's proof of SB 792 Adult Immunization's verified.

Continued on 809-C
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
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: HUBBELL FCC AKA KELLIE'S KIDS
FACILITY NUMBER: 566214138
VISIT DATE: 02/11/2020
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
26
27
28
29
30
31
32
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

A Guide to Safe Sleep and Effects of Lead Exposure brochures were provided.


No deficiencies were cited during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED.
SUPERVISOR'S NAME: Ana TolentinoTELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-LaxoTELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020
LIC809 (FAS) - (06/04)
Page: 2 of 2