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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406215848
Report Date: 08/06/2024
Date Signed: 08/06/2024 05:35:05 PM

Document Has Been Signed on 08/06/2024 05:35 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:HENDERSON FAMILY CHILD CARE AKA ABACUS CHILDCAREFACILITY NUMBER:
406215848
ADMINISTRATOR/
DIRECTOR:		ANNETTE ELAINE HENDERSONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 440-2559
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
08/06/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:20 PM
MET WITH:Annette Henderson TIME VISIT/
INSPECTION COMPLETED:
05:45 PM
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On 8/6/2024 at 3:20 PM, Licensing Program Analysts (LPAs) Gigi Reyes and Shane Loftus conducted an unannounced 3 year required inspection at the above Family Child Care Home (FCCH). LPAs met with Licensee, Annette Henderson. LPAs discussed the purpose of the inspection. FCCH operates Monday to Thursday, 7:30 AM to 4:30 PM. Licensee cares for children 0-12 years old.

LPAs and Licensee toured the inside and outside of the home. LPAs observed 5 napping children in the day care room and 2 infants in the bedroom downstairs.

This is a 2 story home with 5 bedrooms and 3 baths. Accessible areas for children are the playroom, one bathroom, one bedroom and the fenced backyard. Off limit areas are living room, kitchen, dining and upstairs. There is a gate at the bottom of the staircase making it inaccessible to children. The playroom is also barricaded with a retractable gate.
The home is clean and organized, bathroom for children’s use is free of toxins. Smoke and carbon monoxide detectors were observed, the regulation fire extinguisher was serviced on 10/18/2023. Age-appropriate toys, book, cots, and playpen and equipment were observed in the home. LPAs also observed age-appropriate play equipment and toys in the backyard. LPAs observed the hot tub that appears secured, however one of the latches that is against the wall is broken.

Continued on LIC 809 C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: HENDERSON FAMILY CHILD CARE AKA ABACUS CHILDCARE
FACILITY NUMBER: 406215848
VISIT DATE: 08/06/2024
NARRATIVE
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LPAs reviewed the facility file and found that the Pediatric CPR and First Aid certificate expires on 4/22/2025 while Mandated Reporter Training expires on 7/25/2026. LPAs reminded Licensee of their responsibility to renew the required training. Children’s records were reviewed and found that the Licensee checks and documents the napping infant every 15 minutes. The Individual Safe Sleep Plan was completed for infants 0-12 months old. Licensee stated that FCCH conducts and documents fire and disaster drill every 6 months, last drill was conducted on April 20, 2024.

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.

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
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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: HENDERSON FAMILY CHILD CARE AKA ABACUS CHILDCARE
FACILITY NUMBER: 406215848
VISIT DATE: 08/06/2024
NARRATIVE
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LPA discussed the safe sleep regulations with licensee, Annette Henderson 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, 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.

The FCCH is not providing Incidental Medical Services (IMS). 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, Annette Henderson was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the LICENSEE, Annette Henderson confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

Continued on LIC 809C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
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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: HENDERSON FAMILY CHILD CARE AKA ABACUS CHILDCARE
FACILITY NUMBER: 406215848
VISIT DATE: 08/06/2024
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During today’s inspection, deficiency was cited under Title 22 Division 12.

A notice of site visit was given to Licensee and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

Exit interview conducted and report was reviewed with the licensee, Annette Henderson.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/06/2024 05:35 PM - It Cannot Be Edited


Created By: Gigi Reyes On 08/06/2024 at 05:08 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: HENDERSON FAMILY CHILD CARE AKA ABACUS CHILDCARE
FACILITY NUMBER: 406215848

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(5)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, LPAs observed that one (1) of the four (4) latches of the cover is broken and LPA able to lift it with at least 2 inches opening which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/13/2024
Plan of Correction
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Licensee agreed to fix the latch and submit the plan of correction photo/video and letter no later than 8/13/2024. In the meantime, while children are outside, licensee's physical and visual supervision is required.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Maria Mueller
LICENSING EVALUATOR NAME:Gigi Reyes
LICENSING EVALUATOR SIGNATURE:
DATE: 08/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/06/2024


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