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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216641
Report Date: 07/02/2024
Date Signed: 07/02/2024 11:49:05 AM

Document Has Been Signed on 07/02/2024 11:49 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:GLOVE FAMILY CHILD CAREFACILITY NUMBER:
406216641
ADMINISTRATOR/
DIRECTOR:		FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 3DATE:
07/02/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Dawn GloveTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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On 7/2/24 at 9:45 AM, Licensing Program Analysts (LPAs) Elvin Baddley and Elizabeth George conducted an unannounced Random/Annual Inspection of of the abovementioned Family Child Care Home (FCCH) and met with Licensee Dawn Glove. LPAs informed Licensee of the nature and purpose of the inspection. LPAs note the Inspection will also address a request for a change of capacity which was submitted to CCLD in June of 2024. LPAs, in the company of the Licensee, toured the exterior and interior of the FCCH. The FCCH's living room, dining room, kitchen, master bedroom, master bedroom's bathroom and backyard are used for child care services, while the remaining of the home is excluded from child care. At the time of the inspection, LPAs observed three children in care.

The FCCH was orderly and void of hazardous items. Required forms are posted on the FCCH's living room wall. Cleaning compounds in the FCCH are secured and stored under a cabinet sink and in the laundry room. Cleaning compounds are also observed in an elevated location above the sink. Medication in the FCCH is stored on an elevated shelf in a hallway closet which is beyond the reach of children in care. LPAs observed sharps atop the kitchen refrigerator which is beyond the reach of children. The FCCH has a wood stove in the living room which is secured by a child safety lock. LIcensee informs LPAs the stove is decorative and not used. LPAs observed a combination smoke/carbon monoxide detector in the FCCH. The aforementioned was tested at 10:14 AM and found to be operable. The FCCH has a regulation fire extinguisher which was serviced on 6/6/24. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. Toys, furniture and play equipment observed in the FCCH are age appropriate. The home maintains working telephone services. LPAs note the bathroom used by children in care is in safe and sanity operating conditions.

The backyard of the FCCH is enclosed by a combination of wood, cinder block and plastic composite fencing. The footing in the area is varied. Toys and play equipment observed in backyard area are age appropriate. LPAs observed no bodies of water on site. The LIcensee was reminded to ensure children are directly supervised when traveling outside the property. Additionally, LPAs reminded LIcensee to replace outdoor play equipment and furnishing when such items begin to degrade.
(CONT. 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: GLOVE FAMILY CHILD CARE
FACILITY NUMBER: 406216641
VISIT DATE: 07/02/2024
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LPA reviewed the records of children on site. The records were current, complete and possessed emergency contact information and immunization records, among other things. The Licensee's records are current and complete with pedantic CPR and First Aid certifications (EMSA approved) expiring on 4/25/25, and Mandated Reporter training certification expires on 4/10/25 The Licensee informed LPA no firearm or ammunition are stored on site. LPAs not the last fire drill at the facility was completed on 2/9/24.

The Licensee does not provide Incidental Medical Services (IMS). 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.

LPAs 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. LPAs 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 and LPAs completed the RSO profile in FAS on 7/2/24.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was (CONT. 809-C, Page 3)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: GLOVE FAMILY CHILD CARE
FACILITY NUMBER: 406216641
VISIT DATE: 07/02/2024
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reviewed with the Licensee Dawn Glove. LPAs notes the FCCH meets Title 22 Division 12 requirements of a Large FCCH License at this time. LPAs notes a fire clearance was conducted on 6/26/24, by the Paso Robles Fire Department. As such, Licensee is granted licensure for a Large FCCH with a capacity of 14, with an effective date of 7/2/24.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024
LIC809 (FAS) - (06/04)
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