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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191513297
Report Date: 01/17/2020
Date Signed: 01/17/2020 10:50:17 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:JOHNSON FAMILY CHILD CAREFACILITY NUMBER:
191513297
ADMINISTRATOR:MARIE JOHNSONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 569-9309
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:14CENSUS: 3DATE:
01/17/2020
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:16 AM
MET WITH:Marie Johnson, LicenseeTIME COMPLETED:
11:10 AM
NARRATIVE
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Licensing Program Analyst (LPA) Rita Ramos conducted an unannounced case management inspection. LPA met with Marie Johnson, Licensee, who guided analyst on a tour of the facility. There were 3 children upon arrival. Jasmine Pickett, Assistant, was also present upon arrival.

The purpose of the inspection was due to LPA conducting a visit at Kinder Prep Preschool Center #198012292 located directly next door to the Johnson Family Child Care facility. Both facilities are owned by the same Licensee, Marie Johnson. While at the Kinder Prep Preschool Center, LPA observed as Child #1 singularly walked from the Johnson Family Child Care Home into the Kinder Prep Preschool Center. Licensee Marie Johnson was informed on 05/22/14, during a Non-Compliance Conference, that they are to not co-mingle children in care.

Since LPA observed as Child #1 left one facility and entered another, LPA conducted the inspection. Upon entering the Johnson Family Child Care Home, LPA observed that Child #2 was laying in a car seat that was placed on the sofa. LPA advised the Licensee that infants are to not be left in car seats due to car seat being manufactured only for transportation purposes. Child #2 left in a car seat alone poses an immediate health and safety risk and since the car seat was placed on the sofa, the immediate risk is greater (pictures were taken).

Due to the severity of what was observed, LPA provided the Licensee, Marie Johnson, a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS, Never Shake a Baby, and Safe Sleeping practices.

The following deficiency listed on the attached LIC 809 (deficiency page) is being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety. ---------------Page 1 of 2
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: JOHNSON FAMILY CHILD CARE
FACILITY NUMBER: 191513297
VISIT DATE: 01/17/2020
NARRATIVE
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The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee/Director was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee/Director.


Exit interview was conducted with Marie Johnson, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

---------------Page 2 of 2
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JOHNSON FAMILY CHILD CARE
FACILITY NUMBER: 191513297
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/17/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/31/2020
Section Cited

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Personal Rights

To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by LPA observing that Child #2 was observed
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to be in a car seat. The car seat was placed on a sofa. This poses an immediate health and safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Rita RamosTELEPHONE: (323) 981-3985
LICENSING EVALUATOR SIGNATURE:
DATE: 01/17/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/17/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3