426216838-1-16-2024-17-CC-GRES-CZJVWB-20240116154741

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 426216838
Report Date: 01/16/2024
Date Signed: 01/16/2024 03:47:51 PM

Document Has Been Signed on 01/16/2024 03:47 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:	ROULLO FCC AKA HAPPY HEARTS PRESCHOOL		FACILITY NUMBER:	426216838
ADMINISTRATOR:	CYNTHIA ROULLO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 260-3105
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	01/16/2024
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Cynthia Roullo		TIME COMPLETED:	03:46 PM

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This is a change of location, the former License no. was 426215411.

On January 16, 2024 at 1:50 PM. Licensing Program Analyst (LPA) Gigi Reyes conducted an announced pre-licensing inspection at the above Family Child Care Home. (FCCH) LPA met with the applicant, Cynthia Roullo, assistant, Glinda Estes and explained the purpose of the inspection. The applicant has converted the garage into a Junior Accessible Dwelling Unit (JADU) intending to utilize for childcare operation. During the inspection, LPA observed 9 napping children at the applicant’s main residence (License no. 426215411) where childcare was previously being provided.

Applicant submitted the application for change of location on 12/11/2023. The proposed change is to use the JADU for child care operation. Fire Clearance was granted on 1/12/2024.

During the inspection, LPA and applicant toured the interior and exterior of JADU, it has one bathroom, a food preparation counter, a refrigerator, and storage cabinets. JADU has ventilation, electric fan, and heater. LPA observed age-appropriate toys, books, and equipment available for children. In the meantime, FCCH will temporarily use the main entrance of the main house to access the door to the JADU. Applicant stated that day care entrance will eventually be relocated to the left side of the home. Also, the side yard will be transformed to day care children’s playground once the landscaping job starts and gets completed.

Continued LIC 809 C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024

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: ROULLO FCC AKA HAPPY HEARTS PRESCHOOL	FACILITY NUMBER: 426216838
	VISIT DATE: 01/16/2024

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It was noted that knives and cleaning materials are kept inaccessible to children in care. The bathroom is free of hazards. The 2A10 BC fire extinguisher was purchased on 11/14/2023, dual carbon monoxide and smoke detector was observed. LPA did not observe any bodies of water, and the applicant stated that there are no guns and ammunition in the home. Control of property, JADU permits and approval were reviewed.

Applicant’s Pediatric 1st Aid/CPR certificate expires on 3/13/2025, while the Mandated Reporter Training expires on 7/31/2022. Applicant was reminded that AB 1207 and Pediatric CPR should be renewed every 2 years. The applicant stated she has liability insurance.

LPA discussed the requirement for care providers/employees, including volunteers, to obtain immunization against Influenza, Pertussis, Measles, including verification of TB, with applicant's verification being on file.

Prohibited items and equipment in the FCCH, such as walkers, bouncers, etc., were also reviewed with the applicant, as well as the LIC 311D Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Children's record-keeping requirements were also reviewed.

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) 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.

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024

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: ROULLO FCC AKA HAPPY HEARTS PRESCHOOL	FACILITY NUMBER: 426216838
	VISIT DATE: 01/16/2024

NARRATIVE

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LPA discussed the safe sleep regulations with applicant, and discussed the Child Care Licensing Safe Sleep webpage at:
htttps://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.

On this date, 1/16/2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Continued LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024

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: ROULLO FCC AKA HAPPY HEARTS PRESCHOOL	FACILITY NUMBER: 426216838
	VISIT DATE: 01/16/2024

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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 platforms. 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 issuance of license for the new location is pending until the Mandated Reporter Training Certificate is renewed and submitted to CCLD. Advisory notes- technical assistance was issued

A notice of site visit was given to applicant, and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the applicant, Cynthia Roullo.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024

LIC809 (FAS) - (06/04)

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