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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191595964
Report Date: 04/05/2022
Date Signed: 04/05/2022 10:35:01 AM


Document Has Been Signed on 04/05/2022 10:35 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:PHORNSUTIPHAIJIT FAMILY DAY CAREFACILITY NUMBER:
191595964
ADMINISTRATOR:PHORNSUTIPHAIJIT, BLANCAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 806-3276
CITY:DOWNEYSTATE: CAZIP CODE:
90241
CAPACITY:12CENSUS: 3DATE:
04/05/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:20 AM
MET WITH:Blanca Phornsutiphajit, LicenseeTIME COMPLETED:
10:45 AM
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Licensing Program Analyst (LPA) T. Tran arrived at the above licensed facility to conduct a required inspection. About 8:30AM, LPA met with licensee Blanca Phornsutiphajit and observed three children in care. About 8:55 A.M. we toured the accessible areas of the home. LPA observed proper care and supervision of children and ratios.
LPA observed the hand sanitizer, disinfecting wipes, and gloves accessible in the home. The current hours of operation are from 7:00 AM - 5:00 PM; Monday through Friday. This is a single dwelling home consists of 3 bedrooms, 2 bathrooms, a living room/dinning room, a kitchen, a detached garage. Childcare conducted in family room and one bedroom for napping. Children do not have access to the kitchen area and two bedrooms. LPA did not observe a safety gate to make the kitchen inaccessible to children in care. During the inspection, kitchen cabinets observed with the safety latched, no sharp objects accessible to children in care. Licensee acknowledged that children may never enter these off-limit areas. The enclosed backyard observed to be clean with some outdoor equipment available for children. Per licensee, they had removed an additional room located in the backyard of the home which made the backyard an open space. LPA advised licensee to update the outdoor facility sketch and submit to the department by 4/8/22 for the record.
LPA observed all posting requirements accessible to all parents. Licensee had current CPR/First Aid certificates (Exp. 4/2023), fire extinguisher, carbon monoxide and smoke detector meet regulations. Cleaning materials and medications are inaccessible, Licensee stated there are no firearms in the home. The home conducted emergency disaster drill once every six month. Children’s records were reviewed and completed.
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
Licensee was informed of responsibility to report suspected Child Abuse by calling the Child Abuse Hotline at 1-800-540-4000. Also call the Community Care Licensing office and follow up with a written Unusual Incident/Injury Report (LIC 624B). Licensee is reminded that smoking is prohibited on the premises.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/05/2022
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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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: PHORNSUTIPHAIJIT FAMILY DAY CARE
FACILITY NUMBER: 191595964
VISIT DATE: 04/05/2022
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LPA informed the effects of lead exposure for children between ages 1-6 years old are the most at risk for lead poisoning. A copy of lead exposure was provided.
LPA recommended facility to stay updated with information related to Covid-19 from the California Department of Public Health (CDPH) guidelines, including Centers for Disease Control and Prevention (CDC) guidelines to help prevent and protect parents and children in care. LPA advised to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations. LPA informed the Child Care Advocate Program (CCAP) provide many other helpful resources to the licensees and the public. Visit www.cdss.ca.gov to receive important updates.
LPA informed of released PIN 21-15 CCLD related to Kidde Trusense Smoke & combination Smoke/Carbon Monoxide Alarms recall. Visit website for more information: http://kiddetsalarmrecall.rsvpcomm.com/
Beginning January 1, 2018, Health and Safety Code 1596.8662 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. Existing licensees must meet requirements by March 30, 2018. New employees shall have 90 days from date of employment to complete training as required. This training requirement may be met by using the Department’s Office of Child Abuse Prevention (OCAP) online training modules. Visit: https://mandatedreporterca.com
To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.
Licensee 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.
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 [facility representative] 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.
A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Blanca Phornsutiphajit.
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie TranTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
LIC809 (FAS) - (06/04)
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