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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215825
Report Date: 01/16/2024
Date Signed: 01/16/2024 03:32:14 PM

Document Has Been Signed on 01/16/2024 03:32 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: 14CENSUS: 2DATE:
01/16/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Devin A. SolomonTIME COMPLETED:
01:24 PM
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On 1/16/24, Licensing Program Analyst (LPA) Francisca Velazquez conducted an unannounced Required Three-Year Inspection of the Family Child Care Home (FCCH). LPA met with Devin Solomon, Licensee of the FCCH and explained the purpose of the inspection. LPA provided the licensee with entrance checklist. At the time of the inspection, LPA observed two (2) children on site during this inspection, one (1) is licensee’s own biological child.

LPA, in the company of Licensee toured the interior and exterior of the FCCH. This home is a single-story home consisting of a living room, dining room, kitchen, three (3) bedrooms, one (1) bathroom, and an outdoor yard. The licensee reported that daycare service takes place in the living room, dining room, one (1) bedroom, one (1) bathroom and outdoor yard. Meanwhile, the kitchen and two (2) bedrooms are inaccessible to children in care.

The FCCH was observed to be clean and orderly. The FCCH has ventilation to afford for the children’s comfort. LPA observed the kitchen is made inaccessible by means of a secured gate. LPA observed sharps are stored in the kitchen counter. Medication for the family is stored in an elevated cabinet in the kitchen. Cleaning compounds are stored under the sink in the kitchen. LPA notes all areas are inaccessible to children in care. The bathroom used for childcare is clean and free of toxins. LPA observed toys, furniture, and equipment in the FCCH are age appropriate and in good condition. LPA notes there are plenty of activities for children indoors and outdoors.

Required forms are predominantly posted in the parent area of the FCCH. LPA observed smoke and carbon monoxide detectors in the FCCH that were tested at 11:30 AM and were operable. The FCCH has a regulation fire extinguisher on site which was purchased on 1/16/24. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The FCCH maintains working telephone services. The Licensee has no firearms or ammunition on site in the FCCH. CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2024
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: 01/16/2024
NARRATIVE
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LPA and licensee toured the outdoor yard. The outdoor yard is fenced, and all exits are secured. LPA observed children have plenty of natural shading to afford the children in care. Children have access to filtered water by means of individual water bottle that are labeled. LPA observed there are plenty of toys, furniture and equipment that is age appropriate. LPA and licensee discussed removing run down/broken items. LPA observed there are no bodies of water on site.

LPA reviewed children's records. The records are current, complete, and possessed emergency contact information and immunization records. LPA reviewed 15-minute sleep logs and found them to be current. A review of the FCCH's fire drill log shows the last drill occurred on 1/16/24. The licensee's records were reviewed and found to be current and updated. The licensee’s pediatric CPR and First Aid certification was taken on 12/31/23. The licensee’s Mandated Reporter training certificate was taken on 12/30/23.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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.

Licensee was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. 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.

CONT 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
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: 01/16/2024
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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, Devin Solomon confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Devin Solomon.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Francisca Velazquez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC809 (FAS) - (06/04)
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