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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 406216255
Report Date: 07/27/2023
Date Signed: 07/27/2023 03:54:48 PM

Document Has Been Signed on 07/27/2023 03:54 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:BURTON FAMILY CHILD CAREFACILITY NUMBER:
406216255
ADMINISTRATOR:CLARE BURTONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(518) 932-5738
CITY:SAN LUIS OBISPOSTATE: CAZIP CODE:
93405
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 7DATE:
07/27/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Clare BurtonTIME COMPLETED:
04:15 PM
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On 7/27/23, at 1:30 PM, Licensing Program Analyst (LPA) Elvin Baddley conducted a One Year Required Inspection of the abovementioned Family Child Care Home (FCCH). LPA met with Clare Burton, Licensee of the FCCH and explained the purpose of the inspection. LPA, in the company of the Licensee, toured the interior and exterior of the FCCH. The FCCH is four bedroom, three bathroom two story dwelling. The home’s living room, kitchen, hallway bathroom, backyard and first floor guest bedroom are used for child care, while the remainder of the home is excluded. At the time of the inspection, seven children are present, along with an Assistant (cleared and associated).

LPA observed the FCCH to be clean and orderly. The bathroom which is used for care is clean and free of toxins. LPA notes cleaning compounds are secured in a cabinet underneath the kitchen sink and in a secure hallway closet. LPA observed medications and sharps in the FCCH stored on an elevated shelf in the kitchen cabinet which is beyond the reach of children in care. Toys, furniture and equipment in the FCCH are varied and age appropriate.

LPA observed required licensing forms and documents on the wall in the FCCH's living room. The is no fireplace on site however the home has a centralized heating system. LPA observed smoke and carbon monoxide detector in the FCCH. Detector in the first floor hallway were tested at 3:15 PM and found to be operable.

LPA observed a regulation fire extinguisher in the FCCH which was purchased on 3/19/23. LPA reminded the Licensee to either service or purchase a regulation fire extinguisher annually. LPA reviewed the home’s fire/disaster drill log. The most recent fire drill occurred on 6/12/23 .

The FCCH's backyard is enclosed by wooden fencing. The fence’s entry/exit gates are secure. The footing in area is varied. LPA observed a shed in the backyard area which contains household goods. Toys and play equipment in the area are age appropriate. LPA observed no bodies of water on site.
(CONT. 802-C, Page 2)
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE: DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/27/2023
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: BURTON FAMILY CHILD CARE
FACILITY NUMBER: 406216255
VISIT DATE: 07/27/2023
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LPA reviewed a sampling of the children's records. All records reviewed are current and complete. Records included documentation noting 15 minute sleep checks of children in care, immunization records
emergency contact information, among other licensing required documents. LPA also reviewed the Licensee's records. Licensee's records are current and complete with Pediatric CPR and First Aid certifications expiring in 8/28/24 (EMSA approved) and Mandated Reporter training expiring on 5/22/25. LPA notes a dog in on site. LPA reviewed the records for the dog and found vaccination records to be current. Licensee informed LPA firearms and ammunition are stored in the home. LPA reviewed storage of the aforementioned and notes firearms and ammunition are stored separately, inaccessible to children in care and in an excluded area of FCCH.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

Licensee 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.

During the exit interview, the Licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS on 7/27/23.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Clare Burton.
SUPERVISORS NAME: Maria Mueller
LICENSING EVALUATOR NAME: Elvin Baddley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC809 (FAS) - (06/04)
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