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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426215953
Report Date: 09/12/2022
Date Signed: 09/12/2022 03:26:02 PM

Document Has Been Signed on 09/12/2022 03:26 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:HODGES FCC AKA HODGES FAMILY DAYCAREFACILITY NUMBER:
426215953
ADMINISTRATOR:MICHELLE HODGESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 975-2344
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
09/12/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:26 PM
MET WITH:Michelle HodgesTIME COMPLETED:
03:30 PM
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On September 12, 2022 at 1:26 PM, Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced 1 Year Required Inspection and met with Licensee Ms. Michelle Hodges. LPA asked Covid-19 screening questions, licensee's responses indicate there are no COVID 19 exposure on site. Licensee provided LPA a tour of the facility inside and out. There were 9 children present during the inspection 3 of whom are infants. Children were napping when LPA arrived.

During the tour, LPA observed the following: required forms are posted in the wall. FCCH uses the living room, day care room, dining , kitchen, fenced backyard and one bathroom for day care. Appropriate fire extinguisher was serviced on 2/21/2022. LPA observed the carbon monoxide and smoke detectors in the home. Toxins and detergent are kept in the locked inaccessible to children in care. LPA observed age appropriate toys and equipment. LPA did not observe any bodies of water. Licensee stated there are no guns or ammunition in the home.

LPA reviewed the facility file. Pediatric CPR and First Aid Card expires on 2/2023 Licensee and staff renewed the Mandated Reporter Training which will expire on 3/19/2023. Licensee and Staff's immunization records are on file. FCCH conducts fire and disaster drill every 6 months, last drill was conducted on 6/17/2022. Children's roster is current. LPA reviewed children records, the records are current and complete. Licensee and assistant check and document the napping infant every 15 minutes. All infants have LIC 9227 Individual Safe Sleep Plan on file.

Continued on LIC 809C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/12/2022
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: HODGES FCC AKA HODGES FAMILY DAYCARE
FACILITY NUMBER: 426215953
VISIT DATE: 09/12/2022
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FCCH does not provide Incidental Medical Services (IMS). 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.

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 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 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.

During today's inspection, no deficiency was cited.

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

Exit interview conducted and report was reviewed with Licensee, Michelle Hodges
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022
LIC809 (FAS) - (06/04)
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