Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207818
Report Date: 07/27/2018
Date Signed: 07/27/2018 11:07:38 AM

COMPREHENSIVE INSPECTION
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:BRAGG FAMILY CHILD CAREFACILITY NUMBER:
426207818
ADMINISTRATOR:GABRIELA BRAGGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 346-6402
CITY:SANTA MARIASTATE: CAZIP CODE:
93454
CAPACITY:14CENSUS: 6DATE:
07/27/2018
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Gabriela BraggTIME COMPLETED:
11:20 AM
NARRATIVE
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Licensing Program Analyst (LPA) Juvenal Moctezuma made an unannounced visit to the home to conduct an Annual/Random required Inspection. LPA met with Gabriela Bragg and her husband. LPA observed 5 children playing in the garage and watching TV. 1 other child was sleeping in a playpen in licensees daughters room whom she also uses for day-care. Licensee uses her family room, kitchen area, dining room area, one of the rooms for napping, and her garage which is converted into a day-care center setting for care. LPA did a walk through with licensee and observed that the home was free of hazards, toxins, and there were no bodies of water present today. Licensee states that the backyard is off limits to the children in care and instead, licensee takes them to the park that's right around the corner of her home. Licensee has a gate in front of the garage door to keep the children in her garage and make the rest of the house inaccessible.

Licensee keeps her knives and medications in a high cabinet, making them inaccessible to children in care. The fireplace in the family room is properly screened. All the bedrooms in the home are closed and have a child safety plastic door knobs. During the inspection, LPA observed licensees daughter sleeping in one of the bedrooms. Licensees son and husband were in the master bedroom. LPA Observed plenty of toys in the garage. LPA Observed a small plastic play structure, slide, bean bags, cars, and a punching bag. Licensee purchased a new Fire Extinguisher on November 17, 2017. The CPR/First Aid certificate is good till 01/21/12019. Licensee conducted a fire/emergency drill on 02/12/2018. The carbon monoxide and smoke detector were tested and found in working condition. The bathroom was found clean and free of toxins at this time. Licensee took the Mandated Reporter Educators Training on 02/07/2018. LPA notified Licensee that she needs to retake it since that's the incorrect one. Licensee states that her husband, daughter, and herself will take the Mandated Reporter Training AB 1207 later tonight. Licensee does not have verification of her immunization record at this time. A sample of 2 children's records were reviewed and complete. Children's roster was not current. Licensee stated there are no guns or ammunition in the home.
Report continued onto LIC 809-C
SUPERVISOR'S NAME: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2018
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: BRAGG FAMILY CHILD CARE
FACILITY NUMBER: 426207818
VISIT DATE: 07/27/2018
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Licensee is not providing Incidental Medical Services. 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

The following type Type B deficiencies were cited today.

APPEAL RIGHTS GIVEN AND EXPLAINED. Licensee was reminded that it is her responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov.


LPA observed licensee post the Notice of Site visit.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISOR'S NAME: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2018
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: BRAGG FAMILY CHILD CARE
FACILITY NUMBER: 426207818
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/27/2018
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/03/2018
Section Cited
HSC
102417(g)(8)
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Operation of a Family Child Care Home. All homes shall have a current roster of the children. This requirement was not met as evidenced by: LPA doing file review of the children's roster and interview with licensee that she does not have a current roster. C#3 & C#4 were not on licensees roster. This poses a potential health and safety risk to children in care.
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Licensee will update her children's roster and submit proof to CCL by 07/30/2018.
Type B
08/03/2018
Section Cited
CCR
1597.622(a)(1)
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Employees or volunteers at family day care home; immunization requirements; records; exemptions- Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each
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Licensee agrees to get record of her immunization records and get any vaccination she doesn't have and submit proof to CCL by 08/10/2018
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employee and volunteer shall receive an influenza vaccination between... This requirement was not met by Licensee failing to not have proof of her immunization record. This poses a potential health/safety risk to children in care
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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: Deborah AjaoTELEPHONE: (805) 562-0411
LICENSING EVALUATOR NAME: Juvenal MoctezumaTELEPHONE: (805) 689-6267
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2018
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2018
LIC809 (FAS) - (06/04)
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