426216530-4-20-2023-17-CC-MBRT-CR3NUS-20230420104648

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216530
Report Date: 04/20/2023
Date Signed: 04/20/2023 10:47:09 AM

Document Has Been Signed on 04/20/2023 10:47 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:	DOWNHOUR FAMILY CHILD CARE HOME		FACILITY NUMBER:	426216530
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	04/20/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Emily Downhour		TIME COMPLETED:	10:59 AM

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On April 20^th, 2023, at 9:30AM, Licensing Program Analysts (LPAs) Rosie Breault and Dixie Wright conducted an announced inspection for the purpose of performing a pre-licensing inspection. LPA met with applicant Emily Downhour and discussed the purpose of the inspection. LPAs and applicant together toured the interior and exterior of the home. At the time of the inspection there was only applicant present.

During this tour the following was noted:

Family members residing in the home are two (2) adults. Per applicant, the operating hours will be Monday through Friday from 7:30am – 5:00pm

All areas identified on the facility sketch were inspected. This is a single story home which consists of three (3) bedrooms, one and a half (1.5) bathrooms, one (1) living room, one (1) dining room, kitchen, garage, and outdoor play area. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children.

Off limit areas included: All three (3) bedrooms, master bathroom (half bathroom), and garage are excluded from childcare services.

Applicant stated that children will have access to living room, one bathroom, dining room, kitchen, and outdoor play area.

There are age-appropriate toys and napping equipment on the premise. Knives and medication for the family are stored out of children’s reach, inaccessible to children in an elevated cabinet in the kitchen. Kitchen cabinets contain locks. Cleaning compounds are stored under kitchen cabinet secured with a lock. The outdoor area is completely fenced with locks secured and no bodies of water present. Applicant stated no firearms or ammunition are present on property.

CONTINUED ON LIC809C

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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: DOWNHOUR FAMILY CHILD CARE HOME	FACILITY NUMBER: 426216530
	VISIT DATE: 04/20/2023

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The required fire extinguisher 2A10BC was purchased on 4/15/2023. Carbon monoxide detector was tested at 9:55AM and was functioning at the time of the visit. Smoke detector was tested at 10:17AM and was functioning at the time of visit. Applicant was reminded to purchase new or service fire extinguisher yearly. First Aid and emergency kits are available.

The applicant completed the Family Child Care Orientation on 11/25/2022. The applicant has current Pediatric First Aid and CPR which expires 4/19/2025. Applicant took the Preventative Health Training on March 27^th, 2023. Applicant completed the Mandated Reporter Training on 6/29/2022.

LPA reviewed with applicant the LIC311D, Forms/Records to Keep in Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Applicant 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, 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 applicant, provided applicant with Safe Sleep Information handout, 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 applicant 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.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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: DOWNHOUR FAMILY CHILD CARE HOME	FACILITY NUMBER: 426216530
	VISIT DATE: 04/20/2023

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

The home meets Title 22 Division 12 requirements of a small FCCH license.

Effective date of license will be noted as the present 4/20/2023.

An exit interview was conducted, report reviewed, and copy provided to applicant.

SUPERVISORS NAME: Ana Tolentino
LICENSING EVALUATOR NAME: Maryrose Breault
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC809 (FAS) - (06/04)

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