566214429-7-8-2019-17-CC-LVIA-BDVVNQ-20190708163531

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566214429
Report Date: 07/08/2019
Date Signed: 07/08/2019 04:35:53 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:	MOTTARD FAMILY CHILD CARE		FACILITY NUMBER:	566214429
ADMINISTRATOR:	STEPHANIE MOTTARD		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 388-7659
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93010
CAPACITY:	14	CENSUS: 7	DATE:	07/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Stephanie Mottard		TIME COMPLETED:	04:30 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) Laura Villanueva made an unannounced Random Annual visit to the home. Met with Licensee, Stephanie Mottard and explained the purpose of the visit. A tour of the one story home was made both inside and outside. The fireplace is covered with 3-2 shelf book cases. The Licensee uses the living room, two bedrooms, hall bathroom, and kitchen for the child care. The Licensee has guns stored separately from the ammunition in locked safes. The regulation fire extinguisher was serviced on 2/4/19. Licensee is reminded to either service or purchase a regulation fire extinguisher every year. The smoke/carbon monoxide detectors were observed. The Licensee uses the back yard for the day care and it is completely enclosed by a fence with gates. There is a hot tub in the yard that is securely locked and inaccessible to the child care children. There are age appropriate toys and equipment. LPA reviewed the children roster and it is up to date. The last fire drill was conducted on 5/8/19. LPA reviewed children's records. They were all complete with the required paperwork. Licensee's First Aid/CPR certificate is valid through 2/5/21. LPA reviewed SB 792 (Child Care Employee and Volunteer: Immunization and Tuberculosis Requirements). Licensee is current with requirement. Mandated reporter training was completed for Licensee and Assistants. Incidental Medical Services (IMS) policy was discussed. Licensee is not providing IMS at the present time. 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 Continued on LIC 809C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

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: MOTTARD FAMILY CHILD CARE	FACILITY NUMBER: 566214429
	VISIT DATE: 07/08/2019

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Licensee is reminded that she is responsible for knowing the regulations for a Family Child Care Home and that Licensing information can be accessed online at www.ccld.ca.gov.

LPA reviewed and provided Licensee with Guide to Infant Safe Sleep, Poisonous Plants poster, and Child Care Quarterly Update-Spring/Summer 2019.

No deficiencies were cited during today's visit.

The LIC 9213 (Notice of Site visit) was posted during today's visit.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY.

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Laura Villanueva	TELEPHONE: (805) 722-5138
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2019

LIC809 (FAS) - (06/04)

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