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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 566215698
Report Date: 03/19/2021
Date Signed: 03/25/2021 10:34:41 AM

Document Has Been Signed on 03/25/2021 10:34 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:MASTER FCC AKA FANNIE'S DAY CAREFACILITY NUMBER:
566215698
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 0CENSUS: 5DATE:
03/19/2021
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:54 PM
MET WITH:Fannie MasterTIME COMPLETED:
02:40 PM
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On March 19, 2021 at 2:00pm, Licensing Program Analyst (LPA) Michael Avila made an announced telephone call to Licensee to conduct a Case Management-Licensee Initiated inspection to increase capacity to her child care license from a small family child care license to a large. LPA met with Fannie Master and advised her the purpose of the inspection. LPA advised licensee that due to COVID-19 and Department of Public Health (DPH) guidelines of social distancing, a tele-inspection would be completed. LPA confirmed with licensee that she had video capabilities with her phone and switched to FaceTime to conduct the inspection. The home is a single story home. The Licensee uses the living room, hall bathroom, and the backyard.The fire clearance was granted on 03/16/2021 by the Ventura County Fire Department. Toxins and hazards are inaccessible to the children. Licensee's CPR first Aid certificate expires 02/13/2022. The backyard is completely fenced. The increase in capacity is granted effective today 03/19/2021.

LPA Avila reviewed COVID-19 guidelines/resources with Licensee. LPA provided COVID-19 Self Assessment Checklist, signs to post. LPA reviewed PIN 20-22 with Licensee. LPA also reminded Licensee of the new child care regulations for infants and to continue monitoring the CCLD website at www.ccld.ca.gov for updates.

“Exit interview was conducted with Fannie Master via tele-inspection, during which the report was explained. This report will be sent to Licensee via email with a read receipt or confirmation of receipt of email, which will act as the Licensee's signature.”
SUPERVISORS NAME: George Mingle
LICENSING EVALUATOR NAME: Michael Avila
LICENSING EVALUATOR SIGNATURE: DATE: 03/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/19/2021
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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