Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334805251
Report Date: 01/21/2016
Date Signed: 01/21/2016 01:18:06 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME:WOLLASTON FAMILY CHILD CAREFACILITY NUMBER:
334805251
ADMINISTRATOR:WOLLASTON, JOSETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(760) 771-9157
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:14CENSUS: 1DATE:
01/21/2016
TYPE OF VISIT:Required - 5 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Josette WollastonTIME COMPLETED:
01:30 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
(1) On date and time listed, Licensing Program Analyst (LPA) Dawn Parker arrived at the facility to conduct an annual visit. LPA toured the facility, inside and out, records were reviewed and the following was observed:
Facility operates: Monday - Friday; 7:00am - 6:00pm
Off limit areas include: Master bedroom and the back and side yard which is fenced separately and contains the shed.
· The facility is operating within the licensed capacity and appropriate ratios
· The Licensee is present in the home and shall ensure that children in care are supervised at all times
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervised children
· A working telephone is present
· Appropriate fire extinguisher, smoke detector and carbon monoxide detector present
· All hazardous items inaccessible this includes: detergents, cleaning compounds, medications and other items which could pose a danger to children
· The Licensee states that they are/are not providing Incidental Medical Services at this time. LPA informed the Licensee that prior to providing any incidental medical services that a written plan must be submitted to the licensing office.
· Storage of poisons shall be inaccessible to children and locked - SEE LIC809D; there is bug spray and paint cans located above the washer and dryer in the hallway. Although the child that is currently in care cannot reach these items. The licensee does care for other children who are older.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
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 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WOLLASTON FAMILY CHILD CARE
FACILITY NUMBER: 334805251
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/22/2016
Section Cited
102416(c)(1)
1
2
3
4
5
6
7
PERSONNEL REQUIREMENTS: (b) ...a licensee of a large family day care home shall ensure that at least one person who has a current certificate in pediatric first aid and pediatric cardiopulmonary resuscitation shall be available at all times when children are present at the facility, or when children are off-site of the
1
2
3
4
5
6
7
The licensee agrees to enroll in a class within the next 30 days and send copies of her updated/current Pediatric CPR and First Aid card when she receives it. The training must take place within the next 90 days.
8
9
10
11
12
13
14
facility for facility activities....

The licensee's Pediatric CPR and First Aid card expired 07/2015 and she has not renewed it as of this date.

8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
LIC809 (FAS) - (06/04)
Page: 7 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WOLLASTON FAMILY CHILD CARE
FACILITY NUMBER: 334805251
VISIT DATE: 01/21/2016
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
· Properly barricaded fire place
· No guns or weapons present as stated by the Licensee
· Home is clean and orderly, with heating and ventilation for safety and comfort
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced or appropriate supervision is present
· Verification of control of property on file - Homeowner has provided mortgage statement
· Facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights poster are posted - Licensee does not have them posted at this time, since she just recently painted the walls in the garage play area. Licensee understands that they must be posted.
· Pediatric CPR and First Aid Card expired on 07/2015 - SEE LIC809D
· Health & Safety Certificate - completed on 07/25/1998 and 08/01/1998 through the Family to Family series given by Riverside County Office of Education. Licensee is informed that if she moves she will be required to retake the Health and Safety training due to new legislation requiring that an hour of nutrition be provided through this training which was not offered when the licensee took the training in 1998.
· No bodies of water
· Clean, safe and age appropriate toys
· Documentation of fire drills on file - last drill conducted on 12/04/2015
· Each child’s file contains a copy of the emergency information card with required information
· The licensee was asked to provide information in regard to having an association to any licensed community care facility. The applicant states she is only associated to her own family child care home.
· All individual subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. This was verified on *01/21/2016*.
· The Department was granted inspection authority as required by the Health and Safety Code.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
LIC809 (FAS) - (06/04)
Page: 2 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WOLLASTON FAMILY CHILD CARE
FACILITY NUMBER: 334805251
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/21/2016
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/22/2016
Section Cited
102417(g)(4)(A)
1
2
3
4
5
6
7
OPERATION OF A FAMILY CHILD CARE HOME: Storage areas for poisons, firearms and other dangerous weapons shall be inaccessible to children and locked.

there is bug spray and paint cans located above the washer and dryer in the hallway.
1
2
3
4
5
6
7
The licensee stated that she would remove the bug spray and any other poisons along with the paint and store them in the shed in the off-limits backyard area and install a lock on the door. The licensee agreed that she would send a picture showing the items removed from the hallway; placed in the shed and how the shed is locked.
8
9
10
11
12
13
14
Although the child that is currently in care cannot reach these items. The licensee does care for other children who are older.

Poisons pose an immediate risk to children.
8
9
10
11
12
13
14
These pictures will be sent to LPA.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
LIC809 (FAS) - (06/04)
Page: 6 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WOLLASTON FAMILY CHILD CARE
FACILITY NUMBER: 334805251
VISIT DATE: 01/21/2016
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
- AB 2236 – Civil Penalties, effective July 1, 2015 – Enacts new civil penalties in cases where the Department determines that a violation of licensing standards resulted in the death or serious injury, or constitutes physical abuse of a child in care. The bill establishes an appeal procedure specific to these civil penalties. The bill also expands the scope of the Child Health and Safety Fund in order to assist parents in securing alternative child care when a Child Care Center or Family Child Care Home license has been suspended or revoked. These civil penalty amounts are scaled in relation to the total capacity of all of the licensee’s facilities and not just the specific facility cited or limited to that facility type.

- Responsibilities of being a mandated reporter
- Access to forms & Regulations for Family Child Care online at www.ccld.ca.gov
- Responsibility to know the regulations for anyone providing care
- Inaccessibility of hazards must be constantly reassessed depending on the children in care
- Current facility’s phone numbers must be on file at all times.
- Baby walkers, bouncy seats, excersaucers and other similar items are prohibited
- The licensee is urged visit the U.S. Consumer Product Safety Commission webpage at
www.cpsc.gov to ensure that equipment used for the day care has not been recalled
- Criminal record clearances required prior to all adults living or working in a Family Child Care
Home. A civil penalty of $100.00 per day per person, may be assessed.
- The Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days.
If a serious violation is cited, a copy of the licensing report (LIC809/LIC9099) must also
be posted for 30 days, as well as any documents showing correction of Type A deficiencies. A
civil penalty of $100 per violation will be assessed for noncompliance.

See LIC809D for cited deficiencies.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
LIC809 (FAS) - (06/04)
Page: 4 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WOLLASTON FAMILY CHILD CARE
FACILITY NUMBER: 334805251
VISIT DATE: 01/21/2016
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The following was reviewed with the licensee(s):
- AB 978 – Zero Tolerance Related Regulations went into effect January 18, 2011 – In accordance with California Health and Safety Code Section 1596.99(c)/1597.58(c) – it was explained that an immediate $150 Civil penalty will be assessed for each serious violation and a civil penalty of $150 per day per violation will be assessed until corrected
- AB 2084 - Nutritious Beverages in Child Care Facilities effective Januay 1, 2012 - was explained that only low-fat or non-fat milk is to be served to children 2 years of age or older; and limit juice to one serving of 100% juice per day; serve no beverages with added sweeteners; and water must be available and accessible to children throughout the day.
- AB 1918 – Smoking prohibition on the premises of Family Child Care Homes, effective January 1, 2015 – This bans smoking tobacco in a home that is licensed as a family child care home, and in those areas of the family child care home where children are present. This change in law was based on demonstrated negative health effects of second and “thirdhand” smoke on children. Thirdhand smoke generally refers to the residue from tobacco smoke that sticks to surfaces after the secondhand smoke has cleared.
- AB 2621 – Public information posted on the internet, effective January 1, 2015 – The Department shall post licensing information for Family Child Care Homes on its Internet Web site to include:
    · The Name
    · The Status of the license
    · The number of citations
    · The number of site visits, including:
      · Non-complaint inspections
      · Substantiated and inconclusive complaint inspections
    This information will be updated at least monthly on the website and will span the preceding five-year period.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
LIC809 (FAS) - (06/04)
Page: 3 of 7


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 700
RIVERSIDE, CA 92501
FACILITY NAME: WOLLASTON FAMILY CHILD CARE
FACILITY NUMBER: 334805251
VISIT DATE: 01/21/2016
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
During the exit interview, the licensee, Josette Wollaston, confirmed that there are no Registered Sex Offenders living in the facility and/or using the facility address for their mailing address.

Appeal rights discussed and a copy of this report was provided to the licensee on this date.

A NOTICE OF SITE VISIT WAS ISSUED AND IS TO BE POSTED IN A PROMINENT LOCATION AT THE FACILITY FOR THE NEXT 30 DAYS ALONG WITH A COPY OF ALL TYPE A DEFICIENCIES (LIC9099D) CITED DURING THIS VISIT. A COPY OF ALL TYPE A DEFICIENCIES CITED DURING THIS VISIT MUST ALSO BE IMMEDIATELY (WITHIN 24 HOURS OF THE CHILD’S NEXT DAY IN CARE) GIVEN TO THE PARENTS OF ALL CHILDREN ENROLLED IN THE CHILD CARE FACILITY AND ANY CHILDREN ENROLLED INTO THE CHILD CARE FACILITY OVER THE NEXT 12 MONTHS (AT THE TIME OF ENROLLMENT). A Confidential Names List was completed and provided to the LICENSEE. A copy of this report must be made available to the public for 3 years.
SUPERVISOR'S NAME: Lya JohnsonTELEPHONE: (951) 782-4216
LICENSING EVALUATOR NAME: Dawn ParkerTELEPHONE: (951) 782-4949
LICENSING EVALUATOR SIGNATURE:

DATE: 01/21/2016
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2016
LIC809 (FAS) - (06/04)
Page: 5 of 7