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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216000
Report Date: 04/28/2022
Date Signed: 04/28/2022 05:11:39 PM

Document Has Been Signed on 04/28/2022 05:11 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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:RUSSELL FCC AKA PITTER PATTER FCCFACILITY NUMBER:
406216000
ADMINISTRATOR:BRITTANY RUSSELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 235-1567
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
04/28/2022
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
03:31 PM
MET WITH:Brittany RusselTIME COMPLETED:
05:25 PM
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On April 28, 2022 at 3:31 PM, Licensing Program Analyst (LPA) Francisco Pedroza conducted an unannounced Annual/Random inspection. LPA met with licensee Brittany Russell and advised her the purpose of the inspection. Licensee provided LPA a tour of the home inside and out. There were seven (7) children in care and one (1) assistant at the time of the inspection.

Licensee uses two rooms, one bathroom, and the backyard for children in care. LPA observed the facility has working smoke and carbon Monoxide detectors. LPA did not observe hazards/toxins accessible to children in care. LPA observed a current 2A10BC fire extinguisher readily available. Licensee advised to ensure the fire extinguisher is serviced or a new one is purchased yearly. LPA observed toys, books, activities, and structures readily accessible for children in care. Licensee uses one room for children to take naps should they want to sleep. Licensee has a large back yard fully enclosed with a fence. Licensee created a fenced outdoor recreation yard within the backyard for children to play in. LPA observed toys, play structures, and equipment in the small recreation yard readily accessible. The rest of the backyard is off-limits and inaccessible to children in care. LPA observed the licensee has a trampoline and spa on a deck in the off-limits area of the back yard. LPA observed the spa fence door swings away and is self latching. The trampoline had a safety net and was secured. Licensee advised the children in care will not be using them. Licensee advised LPA that there are no firearms and live ammunition in the home.

LPA observed the facility roster was current. A sampling of children records were reviewed and found to be current. LPA verified SB792 Child Care Adult Immunization and Tuberculosis requirements. Licensee's Pediatric CPR/First-Aid certificate is current and valid until 9/13/22. Licensee's Mandated Reporter certificate is current and valid until 3/31/24. The last fire drill was completed on 1/15/22. LPA discussed current Safe Sleep and Covid-19 requirements with licensee. LPA provided licensee with Carbon monoxide resource.

Continued on 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE: DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/28/2022
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: RUSSELL FCC AKA PITTER PATTER FCC
FACILITY NUMBER: 406216000
VISIT DATE: 04/28/2022
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No deficiencies were cited during today's inspection.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Home 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: http://www.ada.gov/childqanda.htm.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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. LPA also informed licensee [facility representative] 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisco Pedroza
LICENSING EVALUATOR SIGNATURE:

DATE: 04/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2022
LIC809 (FAS) - (06/04)
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