566215920-2-7-2020-17-CC-BCES-BLL3CY-20200207170842

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566215920
Report Date: 02/07/2020
Date Signed: 02/07/2020 05:08:51 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:	BERKOWITZ TROTTER FAMILY CHILD CARE		FACILITY NUMBER:	566215920
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	02/07/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Kelly Berkowitz		TIME COMPLETED:	05:15 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 February 7, 2020 at 3:30 P.M. Licensing Program Analyst (LPA) Betzayra Cervantes and Licensing Program Manager (LPM) Mingle made an unannounced visit to conduct a Prelicensing inspection. LPA met with applicant Kelly Berkowitz and discussed the nature and purpose of the visit. The applicant was caring for her own child at the time of the inspection. The applicant has a two story five bedroom and three bathroom home. The applicant will be using the living room, dining room, kitchen, back yard, and one bathroom for day-care. On the first floor, the laundry room, toy closet, pantry, and garage will be off limits to children in care. There is a retractable gate at the bottom of the stairs making the second floor inaccessible. Applicant stated that one bedroom upstairs will be used for napping children. LPA did not observe any toxins/hazardous items accessible to children. A 2A10BC fire extinguisher purchased on 05/27/2019 was observed on the kitchen counter. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed the home has functioning smoke and carbon monoxide detectors in the home. There are age appropriate toys and day-care equipment in the home. The back yard has age appropriate toys and materials in good condition and free of hazards. LPA observed sufficient shade for children to have access to. Preventative Health & Safety and Nutrition Training completed on 11/9/19. Applicant First Aid/CPR certificate is valid until 04/24/21. Continued on 809-C

SUPERVISOR'S NAME: George Mingle	TELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020

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: BERKOWITZ TROTTER FAMILY CHILD CARE	FACILITY NUMBER: 566215920
	VISIT DATE: 02/07/2020

NARRATIVE

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Applicant AB 1207 Mandated Reporter Training Certificate expires 10/02/2021. Applicant stated they do not have firearms and ammunition in the home. Applicant stated that she will be purchasing liability insurance. Applicant provided a copy of their lease agreement to verify control of property. Applicant was informed walkers, bouncers, saucer chairs, Johnny jumpers and recalled Fisher Price rock N Play sleeper and all models of kids sleepers are prohibited from licensed facilities.

LPA reviewed, discussed and gave applicant updated samples of state required forms to be kept in the children's file, required forms to be posted and forms that needs to be maintained at the Family Child Care Home (FCCH). LPA discussed information about Sudden Infant Death Syndrome, Never Shake a Baby, and Capacity requirements. A guide to Effects of Lead Exposure and Safe Sleep pamphlets were provided and discussed with the applicant. Applicant was made aware that it is her responsibility to know the regulations for Family Child Care Homes which can be accessed on-line at www.cdss.ca.gov.

No deficiencies cited during this visit. License to operate a Family Child Care facility is effective today 02/07/2020.

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) 562-0411
LICENSING EVALUATOR NAME: Betzayra Cervantes	TELEPHONE: (805) 680-7175
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2020

LIC809 (FAS) - (06/04)

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