191605960-4-10-2023-30-CC-JLAO-CQRSPU-20230410140344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191605960
Report Date: 04/10/2023
Date Signed: 04/10/2023 02:04:05 PM

Document Has Been Signed on 04/10/2023 02:04 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	CORBIN FAMILY DAY CARE		FACILITY NUMBER:	191605960
ADMINISTRATOR:	CORBIN, LUZ P.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 557-1447
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90025
CAPACITY:	14	CENSUS: 7	DATE:	04/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Luz Corbin		TIME COMPLETED:	02:00 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 4/10/2023 at approximately 11:30 a.m. Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection at 1908 Fox Hills Drive, Los Angeles, CA 90025. LPA was greeted by licensee Luz Corbin. Facility operates Monday through Friday 8:30 a.m. to 5:30 p.m. Facility is NOT available for evening and/or weekend care. Currently licensee is available to care for children 6 months old to 5 years old. Licensee confirmed that program does not have any child under the age of 12 months; youngest child enrolled is 18 months. LPA toured the home inside and outside and a census was taken; 7 children were present during the inspection with licensee and assistant A. Ayala Gonzalez. LPA observed children playing in the extra activity space in the back house. Facility is licensed for a Large family child care license with a max capacity of 14. The home is a 2 bedroom, 2 bathroom single family unit with a living room, dining room and kitchen area, front yard and back yard. LPA observed an additional activity space that is used for activities. Licensee confirmed that children nap in the living room area and in bedroom 1. Licensee confirmed the following areas are used for day care: Living room, dining room, bedroom 1, bathroom and extra activity space located in the back of the home. Kitchen area is used only to prepare meals and snacks, children are not allowed in the space. The following areas are OFF LIMITS: bedroom 2 and front yard. LPA observed a carbon monoxide and smoke detector in the napping room/bedroom 1, hallway by the bathroom that children use, living room and extra activity space located in the back of the home.Two working fire extinguishers was observed in the day care space. Families enter the facility through the side of the home that leads to the back yard.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CORBIN FAMILY DAY CARE	FACILITY NUMBER: 191605960
	VISIT DATE: 04/10/2023

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
26
27
28
29
30
31
32

Page 2
The yard was observed with a variety of age-appropriate materials, wooden climbing structured with soft cushioning and a sand area with age appropriate outdoor toys.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents and cleaning compounds are kept in the bathroom sink cabinet- LPA observed a safety latch on the cabinet, making the content inaccessible. They care also stored in the outside patio top shelf. LPA reminded licensee to ensure all areas that have been designated as OFF LIMITS need to remain with closed doors when children are present. Sharp object and knives were observed stored in the top shelf in the kitchen, making the items inaccessible to the children in care.

Safe Sleep regulations were discussed due to program being available for infant care. Currently facility does not have any child under the age of 12 moths old. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Infants up to 12 months of age are placed on their backs for sleeping. Individual Infant Sleeping Plan will be completed. LPA provided licensee a copy of the LIC 9227 to use as a reference.

Adequate heating and ventilation for safety and comfort were observed in the space. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number 310-557-1447.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: CORBIN FAMILY DAY CARE	FACILITY NUMBER: 191605960
	VISIT DATE: 04/10/2023

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
26
27
28
29
30
31
32

Page 3
Capacity as specified on the license is being maintained during today’s inspection.
LPA reviewed a sample of 6 children’s file and all files were complete. Licensee’s Pediatric CPR and First Aid certification was observed; expiration date of 6/2023. Licensee’s Mandated Reporter training was taken on 7/8/2021. A. Ayala Gonzalez did not have current Mandated Reporter training available for review. LPA issues a Technical Violation. LPA discussed the LIC 311D- Records to be maintain in the facility and provided licensee with a current copy to use as a reference when auditing children’s file.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.
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/inspection-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 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.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Exit interview conducted and report was reviewed with the licensee Luz Corbin.
Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Judy Laureano	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 04/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/10/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3