406216634-6-22-2023-17-CC-MJIZ-CT2R6W-20230622124526

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 406216634
Report Date: 06/22/2023
Date Signed: 06/22/2023 12:45:36 PM

Document Has Been Signed on 06/22/2023 12:45 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:	ECKMAN FAMILY CHILDCARE		FACILITY NUMBER:	406216634
ADMINISTRATOR:	KATIE ECKMAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 264-5687
CITY:	SAN MIGUEL	STATE: CA	ZIP CODE:	93451
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 1	DATE:	06/22/2023
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Katie Eckman		TIME COMPLETED:	12:55 PM

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This is a change of location, previous facility number 406215627.

On 6/22/2023, at 10:05AM, Licensing Program Analyst (LPA) Martina Jimenez conducted an announced change of location, Pre-licensing inspection. LPA met with Katie Eckman, Licensee, the purpose of the visit was discussed with the Licensee and together we toured the inside and outside of the home. There was one (1) child present at the time of the inspection. The licensee stated the child is licensee own child.

Licensee requested a change of location for a large family child care license and a Fire Clearance was granted on 6/21/2023. The home is a two (2) bedroom, one (1) bath, single story home with a day-care room off the dining room. The licensee will use the kitchen, dining room, day-care room, hallway bathroom, and backyard. The two (2) bedrooms will be off-limits and are inaccessible to children in care. LPA observed the two (2) bedrooms, with door knob covers and safety gates making these areas inaccessible to children. LPA observed the home to be orderly.

LPA observed that knives are stores in a high cabinet in the kitchen. LPA observed age appropriate books, toy, games, tables and chairs. LPA observed toxins and hazardous materials secured and inaccessible to children in care. The bathroom to be used for children in care was observed to be clean and free of toxins.

The yard is completely fenced. LPA observed age appropriate toys, bikes, play structure and playhouses LPA observed one (1) cat, two (2) medium dogs, four (4) birds, and thirty-four (34) CONTINUES 809-C

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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: ECKMAN FAMILY CHILDCARE	FACILITY NUMBER: 406216634
	VISIT DATE: 06/22/2023

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chickens secured and inaccessible to children in care. No bodies of water were observed on site. LPA observed sufficient shade for children in the outdoor play area.

There will be one (1) adult living in the home. Applicant has been fingerprint cleared.

LPA observe a regulation 2A10BC fire extinguisher was observed in the day-care room, that was services on 6/20/2023. Applicant is reminded to service or purchase the fire extinguisher yearly. LPA observed smoke and carbon monoxide detectors were tested at 11:03 AM and were functioning at the time of the inspection.

Licensee stated that there are no weapons/ammunition in the home. Licensee stated she does not hold a foster family license. Licensee is current with immunization required per SB 792. Licensee is current with CPR and First Aid which expires March 29, 2025. Licensee completed the Mandated Reporter Training on August 25, 2023, that is required per AB 1207. Control of property was verified via review of Grant Deed.

Licensee is not providing Incidental Medical Services. Incidental Medical Services (IMS) policy was discussed. 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: htttp://www.ada.gov/childqanda.htm

LPA reviewed the handout "A Child Care Provider's Guide to Safe Sleep" (PIN 20-24) and Effects of Lead Exposure. LPA provided a Handout for Reporting Child Abuse and Neglect Training provided online at www.ccld.ca.gov. Applicant was made aware the responsibility to know the regulations for Family Child Care Home which can be accessed on-line at www.ccld.ca.gov..

The home meets Title 22 Division 12 requirements of a Large FCCH license. Effective date of license will be noted as 6/22/2023.

Exit interview was conducted with Katie Eckman, licensee, There were no deficiencies cites at this time. 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. THIS REPORT MUST BE FILED IN FACILITY FILE AND MADE AVAILABLE FOR PUBLIC REVIEW FOR 3 YEARS.

SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Martina Jimenez
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

LIC809 (FAS) - (06/04)

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