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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406211295
Report Date: 07/20/2021
Date Signed: 07/20/2021 10:50:55 AM

Document Has Been Signed on 07/20/2021 10:50 AM - It Cannot Be Edited

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:GATES FCC AKA TOWN & COUNTRY DAY PRESCHOOLFACILITY NUMBER:
406211295
ADMINISTRATOR:AMY SUZANNE GATESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 541-8696
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
07/20/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Amy GatesTIME COMPLETED:
11:00 AM
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On 7/20/21, at 9:00 AM, Licensing Program Analyst (LPA) Elvin Baddley conducted an unannounced Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Amy Gates, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of Licensee, toured the interior and exterior of the FCCH. The home’s living room, family room backyard and hallway bathroom are used for child care services, while the home’s bedrooms and second bathroom are excluded from child care. At the time of the inspection eight (one biological) children are present.

The home was orderly and void of hazards. LPA observed the bathroom used for child care to be clean and free of toxins. Licensee informed LPA no medication is on site, however if medication were present the medication would be stored in an elevated kitchen cabinet, inaccessible to children in care. LPA also observed cleaning compounds stored on an elevated shelf in a kitchen cabinet and in the FCCH's garage, inaccessible to children in care. Likewise, LPA observed sharps stored in an elevated shelf in the kitchen area. .Toys, furniture and equipment observed in the FCCH are age appropriate.

Required licensing forms and documents are posted on the wall of the family room. The home’s living room has a fireplace filled with decorative wood.. The Licensee informed LPA the fireplace is not operable and the placement of the wood leaves the fireplace inaccessible to children in care. LPA observed smoke and carbon monoxide detectors in the FCCH. Each detector was tested (9:45 AM) and found to be operable. LPA observed a regulation fire extinguisher in the FCCH which was last serviced on 1/12/21.. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log. The most recent fire/disaster drill occurring on 5/11/21. The FCCH maintains an operable telephone services.

The backyard is enclosed by wooden fencing. The fence gates were secure . Toys and play equipment observed in backyard area is age appropriate and in satisfactory condition. No bodies of water were
(CONT. 809-C)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/20/2021
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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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: GATES FCC AKA TOWN & COUNTRY DAY PRESCHOOL
FACILITY NUMBER: 406211295
VISIT DATE: 07/20/2021
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observed on site.

A sampling of the children records were reviewed. The children's records are complete and current. LPA reviewed the facility's roster and noted the children present are contained on the facility's roster. The Licensee’s records are also current and complete with Pediatric CPR and First Aid certifications expiring on 6/20/23, and Mandated Reporter Training expiring 9/1/21. Licensee was reminded of the intervals the aforementioned needed to be renewed.

The Licensee stated no firearms or ammunition is on stored on site.

The Licensee is not providing 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: www.ada.gov/childqanda.htm

LPA discussed COVID 19 guidance and best practices with the Licensee. Licensee was reminded that it is Licensee's responsibility to know the regulations for a FCCH which can be accessed on-line at www.ccld.ca.gov.

In areas evaluated, there were no deficiencies cited at this time.

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
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2021
LIC809 (FAS) - (06/04)
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