Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 421712407
Report Date: 03/26/2019
Date Signed: 03/26/2019 02:49:08 PM

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:CARPENTER FAMILY CHILD CAREFACILITY NUMBER:
421712407
ADMINISTRATOR:CARPENTER, JULIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 733-2204
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:14CENSUS: 12DATE:
03/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Julia CarpenterTIME COMPLETED:
03:00 PM
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An annual random was conducted by LPAs S. Mendoza-Ceja and Jill Laxo who met with Licensee Julia Carpenter. The home was toured inside and outside, including the upstairs area. The home was observed to be clean and orderly. Licensee stated there are no firearms, ammunition or bodies of water on the premises. LPA did not observe any bodies of water. LPAs did not observe any toxins accessible to children. The 2A10 BC Fire Extinguisher was serviced in February 2019. Licensee was reminded the Fire Extinguisher needs to be serviced or replaced yearly. The last fire drill was conducted 02/21/2019. There is a combination smoke/carbon monoxide detector in the home. The children’s records were reviewed. The handouts “A Child Care Provider’s Guide to Safe Sleep and Effects of Lead Exposure” were reviewed with Licensee. Licensee's CPR and First Aid is current (expires 03/21/2021). LPA discussed the requirement for care providers/employees, including volunteers to obtain immunization against Influenza, Pertussis, and Measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. Verification was available for licensee and her assistant. Licensee and her assistant completed AB 1207 Child Mandated Reporter Training as required.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes 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

No deficiencies cited. The "Notice of Site Visit" was posted at the visit.

FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY
SUPERVISOR'S NAME: George MingleTELEPHONE: (805) 562-0412
LICENSING EVALUATOR NAME: Sylvia Mendoza-CejaTELEPHONE: (805) 722-5132 FAX 685-1820
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2019
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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