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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 426207382
Report Date: 07/14/2021
Date Signed: 07/14/2021 11:50:48 AM

Document Has Been Signed on 07/14/2021 11:50 AM - 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:PENK FCC AKA LITTLE SHINING STARSFACILITY NUMBER:
426207382
ADMINISTRATOR:LAUREL PENKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(805) 934-3958
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY: 14TOTAL ENROLLED CHILDREN: 0CENSUS: 11DATE:
07/14/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:32 AM
MET WITH:Laurel PenkTIME COMPLETED:
12:00 PM
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On 7/14/21, at 10:32 AM, Licensing Program Analysts (LPAs) Gigi Reyes and LPA Francisca Velazquez conducted an unannounced Required 1 year inspection of the facility. Prior to entering the facility, LPA completed COVID-19 pre-screening questionnaire with Licensee, based on responses it was determined that there are no COVID-19 exposures in the facility. The LPAs met with Laurel Penk, Licensee of the FCCH and explained the purpose of the inspection. LPAs, in the company of Licensee, toured the interior and exterior of the FCCH. This home consists of three (3) bedrooms, two (2) bathroom with garage. Licensee mainly uses two (2) bedrooms, bathroom and backyard for daycare needs. Areas inaccessible to children in care consists of living room, dinning/family room, kitchen, one bedroom and garage. At the time of the inspection, 11 children are present. Facility offers two sessions per day Monday through Friday. AM session is from 8:30 AM-11:30 AM and PM session is from 12:30 PM - 3:30 PM.

Required forms are predominantly posted on the wall of the facility. LPAs observed a smoke and carbon monoxide detector in the ceiling of the facility. The detectors were tested at 10:46 AM and 10:48 AM and were found to be operational. Licensee stated that last emergency drills was conducted and documented on 5/13/21. The home has a regulation fire extinguisher which was serviced on 6/2/21. LPAs reminded the Licensee to either service or purchase a regulation fire extinguisher annually. The home maintains working telephone services.

The home was clean, orderly and has ventilation to afford for the children’s comfort and safety. Further, the home was void of hazardous items. Vitamins in the home is stored in the kitchen in a high cabinet which is inaccessible to children. Cleaning compounds are stored in the laundry room and are inaccessible to children. Toys, furniture and equipment observed in the home are safe, varied and age appropriate.

CONT 809-C
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2021
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 2
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: PENK FCC AKA LITTLE SHINING STARS
FACILITY NUMBER: 426207382
VISIT DATE: 07/14/2021
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The backyard is completely fenced. LPA observed plenty of manipulative and gross motor equipment accessible to children in care. The fence’s entry/exit gates were secure. Toys and play equipment observed in backyard are safe, varied, age appropriate and in satisfactory condition. No bodies of water were observed on site.

LPA reviewed children records. The records were current, complete and possessed emergency contact information as mandated by regulations. The Licensee's records are also current and complete with CPR and First Aid certifications expiring on 6/12/23. LPAs observed a Mandated Reporter Certification which expires on 1/5//22. Licensee is up to date with immunization's.

The Licensee possess no firearms or ammunition are stored on site.

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

LPAs discussed COVID-19 best practices and guidance. Likewise, LPAs discussed safe sleep regulations with the Licensee. Licensee stated that she does not care for an infants at this time. Licensee was reminded that it is her responsibility to know the regulations for FCCH which can be accessed on-line at www.ccld.ca.gov.

There were no deficiencies cited at this time.

THE NOTICE OF SITE VISIT WAS POSTED AS REQUIRED BY H&S CODE SEC. 1596.817. THE NOTICE OF SITE VISIT MUST REMAIN POSTED FOR 30 DAYS OR A CIVIL PENALTY OF $100.00 WILL APPLY
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Gigi Reyes
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021
LIC809 (FAS) - (06/04)
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