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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215210
Report Date: 01/21/2025
Date Signed: 01/21/2025 01:50:07 PM

Document Has Been Signed on 01/21/2025 01:50 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:WILLIAMS FCCFACILITY NUMBER:
426215210
ADMINISTRATOR/
DIRECTOR:		WILLIAMS, VERONICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 363-7127
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 3DATE:
01/21/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:52 AM
MET WITH:Veronica WilliamsTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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On January 21, 2025, at 10:52 AM, Licensing Program Analysts (LPAs) Elizabeth George and Bill Billones conducted an unannounced required annual/ random Inspection at the above mentioned Family Child Care Home (FCCH). LPAs met with Licensee Veronica Williams and explained the purpose of the inspection. LPAs, in the company of the Licensee, toured the interior and exterior of the facility. At the time of the inspection 3 children were present.

Licensee stated that children have access to living room, bathroom, kitchen,one bedroom and backyard. The home was orderly and clean with proper ventilation for all children in care. LPAs observed Clorox and hair care products in the bathroom. Licensee removed both Clorox spray and hair products to a locked closet in off limits bedroom. LPAs observed that sharps, knives, and medications are stored in an elevated kitchen cabinet that is inaccessible to children in care. Cleaning compounds are kept in an off limits area of the FCCH. Toys, furniture and equipment in the facility are age appropriate.

LPAs observed required licensing forms and documents posted in the facility. LPAs observed a dual smoke detector/carbon monoxide detector which was tested and found to be operational at 11:18 AM. LPAs observed a regulation fire extinguisher that was last serviced on 7/18/23. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPAs reviewed the home’s fire drill log with the recent fire drill conducted 12/8/24.

LPAs observed that the backyard is completely fenced. LPAs observed plenty of gross motor activities and shade for the children in care. Toys and play equipment observed in backyard are age appropriate and in good conditions. LPAs observed no bodies of water on site. LPAs reminded licensee to keep the garage door locked making it inaccessible to children. Licensee informed LPAs no firearms or ammunition are in the home.

809-C continued on page 2
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Elizabeth George
LICENSING EVALUATOR SIGNATURE: DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/21/2025
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 6
Document Has Been Signed on 01/21/2025 01:50 PM - It Cannot Be Edited


Created By: Elizabeth George On 01/21/2025 at 12:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: WILLIAMS FCC
FACILITY NUMBER: 426215210

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)(4)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in licensee had clorox spray and hair care products in the bathroom accessible to children which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/21/2025
Plan of Correction
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Licensee removed clorox spray and hair products to a locked closet in an off limits bedroom during inspection.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Elizabeth George
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


LIC809 (FAS) - (06/04)
Page: 2 of 6
Document Has Been Signed on 01/21/2025 01:50 PM - It Cannot Be Edited


Created By: Elizabeth George On 01/21/2025 at 12:41 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: WILLIAMS FCC
FACILITY NUMBER: 426215210

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in the count of the fire extinguisher was last serviced on 7/18/23 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2025
Plan of Correction
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Licensee will either service or purchase a regulation fire extinguisher and email proof to elizabeth.george@dss.ca.gov no later than 2/14/25.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in licensee madated reporter certification is expired which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/14/2025
Plan of Correction
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Licnesee will complete the Mandated Reporter certification and email proof to elizabeth.george@dss.ca.gov no later than 2/14/25.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Ana Tolentino
LICENSING EVALUATOR NAME:Elizabeth George
LICENSING EVALUATOR SIGNATURE:
DATE: 01/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/21/2025


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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: WILLIAMS FCC
FACILITY NUMBER: 426215210
VISIT DATE: 01/21/2025
NARRATIVE
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LPAs reviewed a sampling of the children records. All records reviewed are current and contains complete emergency card information. Facilities current roster of children was reviewed by the LPAs during inspection. All children present during the inspection are noted in the roster. LPAs reviewed the Licensee’s Pediatric CPR and First Aid certifications which expire 2/27/25 and Mandated Reporter Training Certificate expired 6/8/24. LPA reminded licensee it is their responsibility to maintain up to date certifications. LPAs advised licensee of requirements for assistants, a criminal record clearance must be approved before initial presence in a FCCH.

Licensee was reminded that all adults 18 and over living or working in the home, 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.

Licensee does not care for children aged 24 months or younger. 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. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.
809-C continued on page 3
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Elizabeth George
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
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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: WILLIAMS FCC
FACILITY NUMBER: 426215210
VISIT DATE: 01/21/2025
NARRATIVE
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Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

During today's inspection, deficiencies were cited under Title 22 Division 12 and Health and Safety Code

LPA George informed Licensee Veronica Williams this report dated 1/21/25 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care.

Also, LPA George informed Licensee to provide a copy of this licensing report dated 1/21/25 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted, appeals rights were provided and report was reviewed with the licensee Veronica Williams.
SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Elizabeth George
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2025
LIC809 (FAS) - (06/04)
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