<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191609286
Report Date: 07/29/2019
Date Signed: 07/29/2019 05:51:28 PM

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:HOFFMAN FAMILY DAY CAREFACILITY NUMBER:
191609286
ADMINISTRATOR:TAMARA AND SIMON HOFFMANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 371-6809
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:12CENSUS: 10DATE:
07/29/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Tamara HoffmanTIME COMPLETED:
06:00 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 7/29/19 at 2:30 PM Licensing Program Analyst (LPA) Angelica Ramirez and Licensing Program Manager (LPM) Sharalyn Jenkins-Sweeten met with Licensee, Tamara Hoffman for the purpose of an annual inspection. Upon arrival, LPA observed 10 children being supervised by licensee and two assistants. LPA observed a child sleeping in an off limits bedroom with no adult supervision. This will result in a Type A and B citation. All adults were fingerprinted and associated to the facility. LPA Ramirez toured and inspected all rooms identified in facility sketch. The facility sketch is outdated and needs to be updated, a new copy must be provided to the department. Hours of operation are from 7:00 am to 5:30 pm, Monday through Friday. The licensee has a dog that is kept on the off limits backyard of the house. LPA reminded licensee to have vaccinations for dog and keep dog food separate from children's food.

This is a two story, four bedroom, three bathroom home with kitchen/dining, living room, laundry room, family room and an attached garage. There is no pool, spa or other bodies of water on the premises. Both licensees currently reside in the home as well as licensee's two adult children. The home has a fireplace that is currently not made inaccessible, it has glass doors but they are not locked. This will result in a Type B citation. The main care area is in the living room, family room and the bathroom in the hallway is accessible to children. The remainder of the home is off limits.

LPA Ramirez observed age appropriate toys, learning materials, games and activities for children in care. All furniture was found in good repair, clean, and without hazards. The kitchen is accessible to children in care. The facility is inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under sink with latch), and hazardous items (sharp knives in kitchen only) that can pose a danger to children. The home has a large amount of clutter in the kitchen and hallway area as well as one of the bedrooms being used as a nap room. This will result in a Type B citation.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
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 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/05/2019
Section Cited
CCR
102417(a)
1
2
3
4
5
6
7
(a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times. facility is providing care per day... This requirement was not met as evidenced by: based on LPA
1
2
3
4
5
6
7
During the inspection the licensee removed the child from the off limits bedroom and added a door knob cover to the off limits bedroom. Licensee will provide a signed declaration stating she shall not
8
9
10
11
12
13
14
observation the licensee had a child sleeping in an off limits bedroom with no supervision. This poses an immediate health and safety risk to children in care.
8
9
10
11
12
13
14
have children in off limits bedrooms and will not leave children unsupervised at any time.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 8 of 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2019
Section Cited
CCR
102417(g)(8)
1
2
3
4
5
6
7
Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841. This requirement was not met as evidenced by: based on observation, the licensee
1
2
3
4
5
6
7
Licensee shall create a new roster and keep it up to date. Licensee will provide a copy of the updated facility roster to the department by 8/16/19.
8
9
10
11
12
13
14
failed to provide a current copy of the facility roster. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Type B
08/16/2019
Section Cited
CCR
102417(g)(A)(1)
1
2
3
4
5
6
7
(A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. 1. The licensee shall document the drills, including the date and time of each drill. This documentation
1
2
3
4
5
6
7
Licensee shall conduct a fire and disaster drill by 8/16/19 and provide proof to the department. Licensee understands she must conduct fire and disaster drills every six months and record them.
8
9
10
11
12
13
14
shall be kept at the family child care home. This requirement was not met as evidenced by: based on observation the licensee failed to conduct a drill within the last six months. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 6 of 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2019
Section Cited
CCR
102417(b)
1
2
3
4
5
6
7
(b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement was not met as evidenced by: based on LPA observation the licensee has
1
2
3
4
5
6
7
Licensee shall remove the clothes, boxes, and similar items of clutter from the hallway and kitchen area by 8/29/19 and provide proof to the department.
8
9
10
11
12
13
14
boxes, clothes, and similiar items stacked in the hallway and kitchen area. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 7 of 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
VISIT DATE: 07/29/2019
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
The licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analyst of any person who will be visiting regularly or for longer than one week. The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation. The "Notification of Parent's Rights" (PUB394) poster must be posted in an area accessible to parents.

The licensee was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles.


New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

Update on Incidental Medical Services (IMS):
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
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/29/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2019
Section Cited
CCR
102417(g)(1)
1
2
3
4
5
6
7
The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (1) Fireplaces and open-face heaters shall be screened to prevent access
1
2
3
4
5
6
7
During the inspection the licensee added a zip tie to the fireplace making the fireplace inaccessible. Licensee agrees to add a long term latch to the fireplace and provide pictures by 8/16/19.
8
9
10
11
12
13
14
 by children. This was not met as evidenced by: based on observation the fireplace was screened but not locked. This poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
Type B
08/16/2019
Section Cited
CCR
102416.3(a)(6)
1
2
3
4
5
6
7
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (6) any change
1
2
3
4
5
6
7
The licensee shall create a new facility sketch for her upstairs and downstairs and will label each room accordingly. Licensee shall ensure off limits bedrooms are made inaccessible with locks or door knob
8
9
10
11
12
13
14
from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided to children in care. This requirement was not met as evidenced by: LPA observed a child sleeping in an off limits bedroom.
8
9
10
11
12
13
14
covers. Licensee will provide proof to the department by 8/16/19.
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: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 5 of 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
VISIT DATE: 07/29/2019
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
Children nap in playpens and mats in the living room. The required fire extinguisher (2A10BC) and smoke detectors are in operable condition. A Carbon Monoxide detector was observed, tested and operable. Home has central A/C and heat. CPR/First Aid expires 6/2020. The facility annual fees are current. Licensee had all the required posted documents: Facility License (LIC 203), Notice of Parent's Rights Poster (PUB 394), Emergency Disaster Plan (LIC 610A), and Earthquake Preparedness Checklist (LIC 9148). Children files were found to be complete (see LIC811). LPA did not observe a recent fire and earthquake drill log or a facility roster, this will result in Type B citations.


The following was discussed with the licensee: Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills, and documentation for both. The role and responsibilities of being a mandated reporter were discussed. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must always have the facility’s phone number. If the phone number has changed, licensing must be notified.
There is an effective 24/7 ban on smoking tobacco in a home that is licensed as a family day care home, and in those areas of the family day care home where children are present.

The licensee was informed of the role and responsibilities of being a mandated reporter, renewal required every 2 years for a licensed child care provider, administrator, or employee
(www.mandatedreporterca.com) Licensee completed mandated reporter training on 1/15/18.

State law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. LPA observed two baby bouncers present at the facility, an advisory note was issued. All infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome). Only children eating may be in high chairs and that car seats are utilized only for transportation
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 2 of 8
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: HOFFMAN FAMILY DAY CARE
FACILITY NUMBER: 191609286
VISIT DATE: 07/29/2019
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
IMS Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.
Incidental Medical Services (IMS) policy was discussed. For further 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
Currently, the facility does not provide Incidental Medical Services - IMS.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. Appeals may be mailed to the following address:

El Segundo Child Care Program Regional Office
300 N Continental Blvd., Suite 290A MS, 29-13
El Segundo, CA 90245

Type A and Type B deficiencies were cited during today's inspection (see LIC 809Ds). Each report (documenting a Type A citation)shall remain posted for 30 days along with the Notice of Site Visit (printed out during this inspection). **In addition; A copy of this report must be provided to the authorized representatives of all currently enrolled children and any newly enrolled child for the following 12 months. The ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC9224) shall be signed and kept in each of the children’s records. The report shall be provided no later than the next business day or the next day the child is in care.

The Licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days.
Exit interview conducted with Licensee. A copy of this report, notice of site inspection, Appeal Rights (LIC 9058), Confidential Names List (LIC 811) and Advisory Notes (LIC9102) were given and explained during this inspection.

SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 07/29/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2019
LIC809 (FAS) - (06/04)
Page: 4 of 8