566211292-7-17-2025-17-CC-SLOS-DJNTXD-20250717150658

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 566211292
Report Date: 07/17/2025
Date Signed: 07/17/2025 03:08:36 PM

Document Has Been Signed on 07/17/2025 03:08 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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME:	FERENCE FAMILY CHILD CARE AKA CREATIVE LITTLE MIND		FACILITY NUMBER:	566211292
ADMINISTRATOR/ DIRECTOR:	TINA TERRIO FERENCE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(805) 341-8468
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 8	DATE:	07/17/2025
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Madelon Smith		TIME VISIT/ INSPECTION COMPLETED:	03:20 PM

NARRATIVE

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On 07/17/2025, at 1:30 PM, Licensing Program Analysts (LPAs) Shane Loftus & Seena Parsapour conducted an unannounced Required 3-Year Inspection of the above-mentioned Family Child Care Home (FCCH). LPAs met with Madelon Smith, Assistant of the FCCH and explained the purpose of the inspection. LPAs were informed that the Licensee left 07/17/2025 and will return 07/22/2025. LPAs in the company of the Assistant, toured the interior and exterior of the FCCH. The FCCH is operated out of an Accessory Dwelling Unit (ADU) on the property. At the time of the inspection, LPAs observed four (8) children along with two Assistants providing care and supervision.

The FCCH is clean, orderly, and has ventilation to afford for the children’s comfort. Sharps are stored in a locked drawer in the kitchen area of the ADU. Cleaning supplies are stored on elevated shelves of the ADU. Medications are stored in an elevated cabinet in the kitchen area. LPAs notes all locations are inaccessible to children in care. The bathroom was observed to be clean and free of toxins. Toys, furniture and equipment observed in the FCCH are age appropriate. Required licensing forms and documents are posted on a bulletin board near the entry door of the ADU. LPAs observed a dual smoke and carbon monoxide detector in the FCCH that was tested at 2:45 PM and found to be operable. The FCCH has a regulation fire extinguisher (2A10BC) that was purchased on 04/13/2025. LPAs reminded the Assistant to either service or purchase a regulation fire extinguisher annually.

Continued on 809-C

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Shane Loftus
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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Document Has Been Signed on 07/17/2025 03:08 PM - It Cannot Be Edited

Created By: Shane Loftus On 07/17/2025 at 02:37 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: FERENCE FAMILY CHILD CARE AKA CREATIVE LITTLE MIND	FACILITY NUMBER: 566211292
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.814(a)(1)(B)(i)(I)

Pool Safety

(i) (I) An approved safety pool cover that is manually or power operated and meets the performance standards of ASTM International Standard F1346-23. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in that there is a pool at the Family Child Care Home that does not have a cover or alarm, a safety ring, a 12-foot pole with a body hook, or daily inspection documentation. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2025
	Plan of Correction
1 2 3 4	Licensee will submit proof of correction for the above mentioned deficiencies to CCLD (shane.loftus@dss.ca.gov) by 07/31/2025.

Type B

Section Cited

CCR

102417(a)

Operation of A Family Child Care Home

(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee did not comply with the section cited above in that the licensee was not present at the Family Child Care Home during operatoin. Licensee is not scheduled to return until 07/22/2015. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2025
	Plan of Correction
1 2 3 4	Licensee will submit a written plan of correction to CCLD (shane.loftus@dss.ca.gov) explaining that she understands that the regulation was violated and how she will avoid repeating this deficiency from reoccuring in the future.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:

	Shane Loftus
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/17/2025 03:08 PM - It Cannot Be Edited

Created By: Shane Loftus On 07/17/2025 at 02:37 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: FERENCE FAMILY CHILD CARE AKA CREATIVE LITTLE MIND	FACILITY NUMBER: 566211292
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/17/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in that both assistants do not have current Mandated Reporter (AB1207) training, this poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/31/2025
	Plan of Correction
1 2 3 4	Licensee will submit proof of current Mandated Reporter (AB1207) trainings for both Assistants to CCLD (shane.loftus@dss.ca.gov) by 07/31/2025.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

	Maria Mueller
NAME OF LICENSING PROGRAM MANAGER:

	Shane Loftus
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: FERENCE FAMILY CHILD CARE AKA CREATIVE LITTLE MIND	FACILITY NUMBER: 566211292
	VISIT DATE: 07/17/2025

NARRATIVE

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The backyard is enclosed by chain linked fencing and the entry/exit points are secured. The footing in the area is varied. The backyard contains age-appropriate toys and play equipment. LPAs reminded Assistant to replace toys and play equipment when such items begin to degrade or are not in good repair. LPAs observed a locked shed in the backyard which contains household supplies and child care supplies. LPAs observed a goat, chicken, and parakeets in the backyard area. LPAs were informed children are under direct supervision when interacting with the animals. At 2:00 PM, LPAs observed a pool in the backyard. LPAs note the pool does not have a cover or alarm, a safety ring, a 12-foot pole with a body hook, or documentation of a daily inspection.

The children’s records were reviewed. The records are current and complete with emergency contact information, immunization records, amongst other required licensing forms. The Assistants’ records were reviewed. At 2:15 PM, LPA’s note both Assistants do not have current Mandated Reporter training. The remainder of the file’s were found to be current with CPR/First Aid training and TB clearance. LPAs notes the most recent fire/emergency drill was conducted on 05/28/2025. The Assistant informed LPAs no firearms or ammunition are stored on site.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Assistant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 809-C

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Shane Loftus
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

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
SANTA BARBARA CC RO, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: FERENCE FAMILY CHILD CARE AKA CREATIVE LITTLE MIND	FACILITY NUMBER: 566211292
	VISIT DATE: 07/17/2025

NARRATIVE

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Assistant 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 Assistant confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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.

Today, Type B Deficiencies are being cited under Title 22 of the California Code of Regulation and Health and Safety Code (see 809-D). Appeal Rights were provided to Licensee. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Assistant, Madelon Smith.

NAME OF LICENSING PROGRAM MANAGER: Maria Mueller
NAME OF LICENSING PROGRAM ANALYST: Shane Loftus
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025

LIC809 (FAS) - (06/04)

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