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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215825
Report Date: 06/08/2021
Date Signed: 06/08/2021 01:11:48 PM

Document Has Been Signed on 06/08/2021 01:11 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:SOLOMON FAMILY CHILD CAREFACILITY NUMBER:
406215825
ADMINISTRATOR:DEVIN ALEXSA SOLOMONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 540-9235
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93401
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 8DATE:
06/08/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Devin SolomonTIME COMPLETED:
01:15 PM
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On 6/8/21, at 12:00 PM, Licensing Program Analyst (LPA) Elvin Baddley and LPA Francisca Velazquez conducted an unannounced Required inspection of the abovementioned Family Child Care Home (FCCH). The LPA met with Devin Solomon, Licensee of the FCCH and explained the purpose of the inspection. LPAs, in the company of the LIcensee, toured the exterior and interior of the FCCH. The home’s living room, guest bedrooms, front yard and hallway restroom are used for child care services, while the home’s master bedroom is excluded from child care. At the time of the inspection, 8 children are present along with two assistants. .

Required forms are predominantly posted on a cabinet in the living room. FCCH does not have a fire place. LPAs observed operable smoke and carbon monoxide detectors in the home . Each detector was tested (12:05 PM 12:50 PM). . Likewise, the home has a regulation fire extinguisher which was service on 9/11/20. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services

The home was orderly and had ventilation to afford for child care services. The FCCH is void of hazardous items. Medication is stored in a medicate cabinet in the bathroom which was inaccessible to children. Cleaning compounds within the FCCH are stored in a locked cabinet underneath the sink. Toys, furniture and equipment observed in the FCCH are age appropriate.

The front yard has artificial grass and wood bark in the play area. The front yard is enclosed by wooden fencing. Toys and play equipment observed in front yard are age appropriate and in satisfactory condition. No bodies of water is observed on site.

A sampling of the children records were reviewed. The records were current, complete and possessed emergency contact information as mandated by regulations. The Licensee's records are also current and (CONT. 809-C)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 06/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/08/2021
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: SOLOMON FAMILY CHILD CARE
FACILITY NUMBER: 406215825
VISIT DATE: 06/08/2021
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complete with CPR and First Aid certifications expiring on 6/15/21. Further, LPA reviewed the Licensee’s Mandated Reporter Training certification was found to be current until 7/25/21.

The Licensee stated firearms or ammunition are stored on site.

The Licensee is not providing 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: www.ada.gov/childqanda.htm

LPAs discussed COVID-19 guidance and best practices with Licensee. Licensee was reminded that it is Licensee's responsibility to know the regulations for FCCH which can be accessed on-line at www.ccld.ca.gov.
In areas evaluated, no deficiencies observed.

The Notice of Site Visit was posted.
FAILURE TO POST THE NOTICE OF SITE VISIT FOR 30 DAYS MAY RESULT IN A $100.00 CIVIL PENALTY.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 06/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/08/2021
LIC809 (FAS) - (06/04)
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