<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406209618
Report Date: 10/03/2024
Date Signed: 10/03/2024 04:29:15 PM

Document Has Been Signed on 10/03/2024 04:29 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME:KELMIS FCC AKA LITTLE PRESCHOOL ON PRAIRIEFACILITY NUMBER:
406209618
ADMINISTRATOR/
DIRECTOR:		MARIE KELMISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 238-4288
CITY:PASO ROBLESSTATE: CAZIP CODE:
93446
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 6DATE:
10/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:05 PM
MET WITH:Marie KelmisTIME VISIT/
INSPECTION COMPLETED:
04:30 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
On 10/03/24, at 2:05 PM, Licensing Program Analyst (LPA) Matthew Sapien conducted an unannounced Annual Random inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Marie Kelmis, Licensee of the FCCH, and explained the nature and purpose of the inspection. The LPA, in the company of Licensee, toured the interior and exterior of the FCCH. The house is a 3-bedroom and 1-bathroom single story home. The home's family room (converted playroom), restroom, living room, kitchen (only accessed for bathroom use), and backyard (two large play areas and an outdoor classroom) are used for childcare services. The excluded areas of the FCCH include the master bedroom and a guest bedroom. At the time of the inspection, six children were present along with one staff assistant (Licensee’s Husband).

LPA observed the FCCH to be clean and orderly. The bathroom, near the kitchen and living room area, which is available for childcare services, is clean and free of toxins. LPAs cleaning compounds are positioned in an elevated shelf in both the restroom and in one of the kitchen cabinets out of the reach of children in care. LPA also observed sharps and personal medication in elevated shelves in the kitchen area, which is also out of reach of children. There are currently no children in care that require medications, however, should medication be needed it would be positioned in an area inaccessible to children in care.

LPA observed age-appropriate toys, furnishings, and equipment throughout the interior areas of the FCCH.

LPA observed licensing forms and documents posted prominently to a board at the entry of the family room (converted playroom). LPA also observed a combination smoke and carbon monoxide detector in the family room (converted playroom) of the FCCH. The carbon monoxide and smoke detector was tested at 2:44 PM and it was found to be operational. LPA observed a regulation fire extinguisher in the FCCH, which was purchased on 1/7/24. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the FCCH's fire/disaster drill log. (CONT. 809-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE: DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/03/2024
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 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: KELMIS FCC AKA LITTLE PRESCHOOL ON PRAIRIE
FACILITY NUMBER: 406209618
VISIT DATE: 10/03/2024
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 most recent fire drill occurred on 9/5/24.

The FCCH's backyard, enclosed by wooden and metal fencing, is also utilized for childcare services. The backyard is made up of two sizable play areas and contains varying surfaces (artificial turf, rocks, and dirt). Like the inside of the home, toys, play equipment, and structures observed in the backyard are age appropriate. LPA observed and confirmed there are no bodies of water on site.

LPA reviewed children's records. All records, licensing documents, and forms were reviewed and are current and complete. LPA also reviewed the Licensee's records. The Licensee's Pediatric CPR and First Aid certifications, expiring on 8/11/25 (EMSA approved) is current and complete. On the contrary, the Licensee's Mandated Reporter Training is expired. As a result of the expiration, Licensee will receive a Type B Deficiency and will have two weeks (10/17/24) to submit proof of correction. LPA reminded Licensee to keep certifications up to date. LPA observed two cats present on site. While the cats don't interact with children in care, the Licensee confirmed that the cats vaccinations are up to date. Licensee also informed LPA that there are no firearms or ammunition on site.

The Licensee informed LPA that Licensee does not provide Incidental Medical Services (IMS) for current children in care. 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

Licensee was reminded that all adults 18 and over living or working in the home, 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 for a maximum of 5-days or, if the penalty is for a repeat violation, for a maximum of 30-days per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at (CONT. 809-C, Page 3).

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117
FACILITY NAME: KELMIS FCC AKA LITTLE PRESCHOOL ON PRAIRIE
FACILITY NUMBER: 406209618
VISIT DATE: 10/03/2024
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
https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as for an additional resource.

LPA also informed Licensee 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.



During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility when the LPA completed an RSO profile in FAS on 10/3/24.

A Notice of Site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Marie Kelmis.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Matthew Sapien
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
Document Has Been Signed on 10/03/2024 04:29 PM - It Cannot Be Edited


Created By: Matthew Sapien On 10/03/2024 at 03:39 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: KELMIS FCC AKA LITTLE PRESCHOOL ON PRAIRIE
FACILITY NUMBER: 406209618

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.866


This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interviewing and record review, the licensee did not comply with the section cited above regarding completion of Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/17/2024
Plan of Correction
1
2
3
4
Plan of Correction: The Licensee will send over proof of completion and correction of Mandated Reporter Training by the end of business day, 10/17/24.

(1) Health and Safety Code Section 1596.866 provides in part:

(a) In addition to any other required training... each family day care home licensee who provides care shall have at least 15 hours of training on preventive health practices. The training shall include pediatric cardiopulmonary resuscitation, pediatric first aid, recognition, management, and prevention of infectious diseases, including immunizations, and prevention of childhood injuries. The training may include training on sanitary food handling, child nutrition, emergency preparedness and evacuation, caring for children with special needs, and identification and reporting of signs and symptoms of child abuse....
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
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:Maria Mueller
LICENSING EVALUATOR NAME:Matthew Sapien
LICENSING EVALUATOR SIGNATURE:
DATE: 10/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/03/2024


LIC809 (FAS) - (06/04)
Page: 4 of 4