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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215522
Report Date: 10/16/2024
Date Signed: 10/16/2024 01:32:01 PM

Document Has Been Signed on 10/16/2024 01:32 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:PERKINS SISK FAMILY CHILD CAREFACILITY NUMBER:
406215522
ADMINISTRATOR/
DIRECTOR:		AMYL PERKINS SISKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 712-6635
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
10/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:05 AM
MET WITH:Amyl Perkins-SiskTIME VISIT/
INSPECTION COMPLETED:
01:40 PM
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On 10/16/24, at 11:05 AM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced Annual Random inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Amyl Perkins-Sisk, Licensee of the FCCH, and explained the nature and purpose of the inspection. The LPA, in the company of Licensee, toured the interior and exterior of the FCCH. The Licensee utilizes a home studio for the interior of the FCCH. The studio's living room (converted play area), bathroom, and backyard are utilized for childcare services, while the remainder of the studio is excluded (two upstairs bedrooms and kitchen). At the time of the inspection, no children were present.

LPA observed the FCCH to be orderly and clean. The bathroom, utilized for childcare services, is clean and free of toxins. Cleaning compounds and sharps were observed in the kitchen area in an elevated area atop the refrigerator out of reach of children in care. More cleaning products, along with some personal medication and hygiene products were observed in an additional kitchen cabinet. Significant to note, the kitchen is made inaccessible to children in care with a child safety gate. Moreover, the LPA observed a secure closet near the bathroom of the FCCH that contains a host of First Aid Kit supplies.

LPA observed age-appropriate toys, books, furnishings, and other equipment throughout the interior (play area) of the FCCH.

LPA observed appropriate licensing forms and documents posted prominently to a bulletin board at the entry of the FCCH. LPA observed a combination smoke and carbon monoxide detector within the FCCH. The combination smoke and carbon monoxide detector was tested at 11:16 AM. The detector was found to be operational. LPA also observed a regulation fire extinguisher in the FCCH, which was last serviced on 9/5/24.

LPA reminded the Licensee to service or purchase a regulation fire extinguisher yearly. LPA reviewed the FCCH's fire/disaster drill log. The most recent fire drill occurred on 6/7/24. (CONT. 809-C, Page 2)

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE: DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/16/2024
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: PERKINS SISK FAMILY CHILD CARE
FACILITY NUMBER: 406215522
VISIT DATE: 10/16/2024
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As noted previously, the backyard is accessible to children in care. The FCCH's backyard is enclosed by wooden and metal fencing. The fence’s entry/exit gates are secure. Like the interior of the FCCH, the backyard has age-appropriate equipment, play structures, and other furnishings throughout the area that can afford for childcare services. The footing in the backyard area is made up of varying surfaces (dirt and concrete pavement). The Licensee was reminded to replace toys and play equipment which start to degrade or are not in good repair. The LPA reminded the Licensee to supervise children in care when engaged in outdoor activity. LPA observed a secure shed in the backyard that contains kids equipment like bicycles and scooters. LPA also observed and confirmed that there are no bodies of water on site.
The Licensee owns one medium-sized dog. The Licensee informed the LPA that the dog does have occasional interactions with children in care and that the dog's vaccinations are up to date.


LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records, among other relevant licensing documents and forms. The Licensee's records were also viewed. The Licensee’s Pediatric CPR and First Aid certifications (EMSA approved) expiring on 6/29/26 and their Mandated Reporter Training, expiring on 4/24/26, is current and complete as are other relevant licensing forms and documents. Licensee was reminded to renew certifications and training prior to expirations. The Licensee verbally stated that there are no firearms or ammunition stored on site.

The Licensee does not currently provide medication or Incidental Medical Services (IMS) to current children in care. IMS policy was discussed. For IMS information see PIN 22-02CCP. 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) or (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.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.



(CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: PERKINS SISK FAMILY CHILD CARE
FACILITY NUMBER: 406215522
VISIT DATE: 10/16/2024
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LPA also informed Licensee of the importance of checking for recalled infant devices on the United States
Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility when the LPA completed a RSO profile in FAS on 10/16/24.

A notice of site visit was given and must remain posted for 30 days. Exit interview was conducted and report was reviewed with the Licensee, Amyl Perkins-Sisk.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024
LIC809 (FAS) - (06/04)
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