566215006-10-25-2019-17-CC-JMHL-BHATQ6-20191025145524

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215006
Report Date: 10/25/2019
Date Signed: 10/25/2019 02:55:31 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:	PARKIN FAMILY CHILD CARE		FACILITY NUMBER:	566215006
ADMINISTRATOR:	KIMBERLY PARKIN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 672-1891
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	14	CENSUS: 5	DATE:	10/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Paige Wood		TIME COMPLETED:	03:00 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 10/25/2019, at 1:50 p.m. Licensing Program Analyst, (LPA) Jill Laxo conducted an unannounced annual inspection at Parkin Family Child Care and met with assistant Paige Wood. The purpose of the inspection was discussed and together we toured the home inside and out. During today's visit there were 5 children in care with two assistants. The facility is a two story home, the day care is primarily conducted on the first floor and in the backyard. Detergents, cleaning products are in a locked room. Medication and other items which could pose a danger are stored in the upper kitchen cabinet and inaccessible to children. There is a pool on the property, which is completely fenced with locks above 5 ft. Licensee states, via phone, there are no firearms in the home. Fire extinguisher is a 2A10BC was last serviced 07/07/2019. The home has working smoke and carbon monoxide detectors. FCCH has all required forms posted for parents to view. The last emergency drill was on 10/11/2019. Safe toys and play equipment are provided. The children have safe and comfortable accommodations. Fireplace is screened. FCCH has current roster of children in attendance. Children files were reviewed and have required forms. Assistants have current CPR/First Aid with expiration date of 03/2020. Proof of SB 792 Adult Immunization's verified and AB1207 Mandated Reporter Training certificate completed for assistants expires on 10/12/2020. Continued on 809C

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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: PARKIN FAMILY CHILD CARE	FACILITY NUMBER: 566215006
	VISIT DATE: 10/25/2019

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

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

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

No deficiencies were cited during today's visit.

SUPERVISOR'S NAME: Ana Tolentino	TELEPHONE: (805) 562-0347
LICENSING EVALUATOR NAME: Jill M Hazelhofer-Laxo	TELEPHONE: (805) 635-5097
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2