191513297-7-19-2023-54-CC-KCHE-CTVT7U-20230719142920

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191513297
Report Date: 07/19/2023
Date Signed: 07/19/2023 02:29:31 PM

Document Has Been Signed on 07/19/2023 02:29 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	JOHNSON FAMILY CHILD CARE		FACILITY NUMBER:	191513297
ADMINISTRATOR:	MARIE JOHNSON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 569-9309
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	14	CENSUS: 4	DATE:	07/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:55 PM
MET WITH:	Marie Johnson, Licensee		TIME COMPLETED:	03:00 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 07/19/2023 at 12:55 PM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Licensee, Marie Johnson, who granted entry to facility and guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. There were four day care children, which includes three infants, napping during today’s inspection. Licensee states that there are currently 25 children enrolled. LPA provided LIC 126 at time of inspection. The children's roster was reviewed and is current. Required postings were observed posted at time of inspection. Facility is also an RFA home, RFA #19R020965. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 06/2023. This is a single-story home which consists of three bedrooms and three bathrooms, kitchen, living room, Infant/Toddler Room, and Daycare Room. Areas used by the children include the Living Room (located to the rear of the home), Infant/Toddler Room (located in the back of the home through Living Room), Daycare Room (located to the left of Infant/Toddler Room), and Bathroom 1 (located in Daycare Room). Per Licensee, areas off limits to children and parents include entire front of the home, which includes all bedrooms, two bathrooms, kitchen and dining room. LPA observed that there are multiple doors separating areas used by children and off-limits areas. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. At 1:03 PM, LPA observed three infants sleeping in cribs and additional sleeping cot and cushioning mat for additional sleeping equipment in Living Room. LPA observed fireplace in Living Room that has been barricaded. At 1:04 PM, LPA observed Infant/Toddler Room to have floor free of hazards and to have age appropriate toys, free of loose and sharp parts. At 1:05 PM, LPA observed Daycare Room to have child appropriate tables and chairs, shelves with child appropriate toys and books available all well Report continues- Page 1 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

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 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JOHNSON FAMILY CHILD CARE	FACILITY NUMBER: 191513297
	VISIT DATE: 07/19/2023

NARRATIVE

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maintained. At 1:07 PM, LPA observed Bathroom 1 to have operable toilet and sink, adequate supplies, and free of hazards at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

Per Licensee, the children will have access to backyard for outdoor play, which LPA observed is accessible through door in Daycare Room. LPA observed backyard has turf grass and adequate perimeter fencing through-out the yard. LPA observed metal play equipment: slide, climbing dome, hanging bar and pole available for children. LPA observed all trees, shrubs, and plants are maintained at time of inspection.

Per Licensee, they provide food for children in care and children use Daycare Room and Infant/Toddler Room for eating. LPA observed child appropriate tables and chairs for eating in Daycare Room and high chairs in Infant/Toddler Rooms for infant eating.

LPA did not observe any pets at time of inspection and Licensee confirms she has no pets. Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or firearms/weapons at time of inspection.

At 1:30 PM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 07/19/2023. LPA observed smoke and carbon monoxide detectors to be present at facility with indicator light green at time of inspection. Per Licensee, First Aid kit is kept in the Daycare Room. The Licensee has current Pediatric First Aid and CPR valid until 02/20/2025. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has proof of completion of AB1207 Mandated Reporter training completed on 04/28/2021. Children records and required licensing forms were discussed.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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: http://www.ada.gov/childqanda.htm

Report continues- Page 2 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: JOHNSON FAMILY CHILD CARE	FACILITY NUMBER: 191513297
	VISIT DATE: 07/19/2023

NARRATIVE

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Licensee (or facility representative) was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed Licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

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.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today, 07/19/2023.

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

Exit interview was conducted and report was reviewed with the Licensee, Marie Johnson.
Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2023

LIC809 (FAS) - (06/04)

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