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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215440
Report Date: 06/24/2021
Date Signed: 06/25/2021 10:11:49 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:MERRITT FAMILY CHILD CAREFACILITY NUMBER:
566215440
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
06/24/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Christine TikotinTIME COMPLETED:
11:00 AM
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This is an Amended report from June 24, 2021.

On June 24, 2021 at 10:02 am, Licensing Program Analyst (LPA) Francisco Pedroza, conducted an announced Case Management inspection. LPA met with Licensee Christine Tikotin and advised her the purpose of the inspection. Licensee provided LPA a tour of the facility inside and out. There was four children in care at the time of the inspection.

Licensee will be using two bedrooms, one restroom, the kitchen, play area, and back yard for care. On June 3, 2021, Ventura County Fire Department inspected the facility and granted a fire clearance for a large family child care. LPA observed a 2A10BC fire extinguisher mounted on the wall in the play area with a service date of 9/2/2020. LPA did not observe any hazards/toxins accessible to children in care. The facility has age appropriate toys and furniture available for children in care. Licensee advised that the facility does not have any firearms or live ammunition in the home. The back yard is enclosed with a wood fence. Licensee has age appropriate toys and equipment in the back yard readily accessible for children in care. There is ample amount of shade for the children.

LPA verified licensee has a Pediatric CPR/First-Aid certificate that expires on 4/20/2022. Licensee's Mandated Reporter certificate expires on 10/29/2021. Currently licensee does not have infants in care. LPA spoke with licensee about current and new Covid-19 and Safe Sleep requirements. Licensee advised that she understood the new requirements.

Effective today June 24, 2021 facility is approved to be a Large Family Child Care with a maximum capacity of 14.

There was no deficiencies cited during the inspection today.
Notice of Site Visit Posted.
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Francisco PedrozaTELEPHONE: (805) 689-4212
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
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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