191805300-2-4-2020-54-CC-DGIS-BLGRMM-20200204120857

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 191805300
Report Date: 02/04/2020
Date Signed: 02/04/2020 12:09:11 PM

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:	DAVIS-PIPKINS FAMILY DAY CARE		FACILITY NUMBER:	191805300
ADMINISTRATOR:	DAVIS-PIPKINS, BRENDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 292-1978
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90037
CAPACITY:	12	CENSUS: 0	DATE:	02/04/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:13 AM
MET WITH:	Brenda Davis-Pipkins		TIME COMPLETED:	12:15 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	Licensing Program Analysts (LPA) Denise Gibbs and Katrina Chicote conducted an unannounced annual random inspection to the above facility on 2/4/2020 at 9:50 AM. LPA's met with Brenda Davis-Pipkins, Licensee who guided analyst on a tour of the facility. Per Licensee, there are 7 children that are currently enrolled. LPA's observed that a current children’s roster was available for review. There were no children present upon arrival. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, front room, living room, kitchen, front yard and back yard (fenced). LPA's observed a back house with a different address 1134 W 41st St. Main care is provided in the living room, kitchen and back yard. The children use the bathroom toward the back of the house in the back bedroom. Per Licensee, areas off limits to children and parents include Front room (used as entrance walkway), 3 bedrooms (1 bedroom is used as an office/storage) and 1 bathroom. Back bedroom is used as a walkway to the children's bathroom. Per licensee all hazardous material is inaccessible. All areas separated by a door. The licensee provides food for children in care. Hours of operation are Mon-Fri 23.5 hours. The licensee states that 1 adult currently lives in the home. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee states that there are no firearms or weapons stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a landline during operation hours. There is ventilation and heating (central). The following was observed and reviewed during this inspection: ------------------Page 1

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

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 5

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: DAVIS-PIPKINS FAMILY DAY CARE	FACILITY NUMBER: 191805300
	VISIT DATE: 02/04/2020

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

During inspection LPA's observed cleaning products and detergents on top of the washing machine accessible to children. Due to no children being in care this is a potential health and safety risk. Licensee was reminded to assess the inaccessibility of the cleaning compounds as the day care children get older and taller. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. Per licensee she uses and exterminator. The restroom that children use was observed to be clean and free of hazards.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was last serviced on 9/2019, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. Children nap on mats in the main care area. Licensee states that she is not currently caring for infants. LPA's did observe 2 infant cribs in the main care area. (not being used for infants at this time)

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA's observed that the outdoor yard has toys and other materials for children to play with. LPA's did not observe any objects that can pose a danger to children on the outdoor yard. There are no pools or spas, or other bodies of water. There are no pets on the premises.

LPA's observed that licensee does have a current pediatric first aid and CPR card which expires 1/2022. There are first aid supplies available.

Children’s records were reviewed, including emergency information and were observed to be complete. LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

The licensee does not have proof of immunization against influenza, pertussis, and measles. LPAs observed that the Licensee and assistant do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

------Page 2

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: DAVIS-PIPKINS FAMILY DAY CARE	FACILITY NUMBER: 191805300
	VISIT DATE: 02/04/2020

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

All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 1/2020.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, inclined sleepers and/or any other item that fall into these categories are. These items are not permitted in a family childcare facility.

Smoking is prohibited in a licensed Family Child Care Home. LPA did not observe anyone smoking in the home.

LPA discussed and provided the licensee with 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, updated Parent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large), Never Shake a Baby pamphlet, updated information on Mandated Reporter Training, and information on prohibiting inclined sleepers for infants.

Health and Safety Code 1596.7996 Effective January 1, 2019, Child Care Centers and Family Child Care Homes are required to provide parents and guardians of children enrolled, enrolling or reenrolling in care with written information on the risks and effects of lead exposure, blood lead testing requirements and recommendations and options for locations of affordable blood lead tests. 2019 Lead flyer Provided.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.
-----Page 3

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

Page: 3 of 5

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: DAVIS-PIPKINS FAMILY DAY CARE	FACILITY NUMBER: 191805300
	VISIT DATE: 02/04/2020

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

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.

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

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are 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.

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.

Exit interview was conducted with Brenda Davis-Pipkins, Licensee, including, but not limited to Appeal Procedures and Appeal Rights. -----------------------Page 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: DAVIS-PIPKINS FAMILY DAY CARE	FACILITY NUMBER: 191805300
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/04/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/04/2020 Section Cited	1 2 3 4 5 6 7	1596.7995 Employees...at day care center...Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on record review licensee did not maintain proof of immunization for S1. This poses a potential Health, Safety or Personal Rights risk to children in care.	8 9 10 11 12 13 14
Type B 02/06/2020 Section Cited	1 2 3 4 5 6 7	102717(g)(4)Operation of a Family Child Care Home...detergents, cleaning compounds...and other items which could pose a danger if readily available to children shall be stored where they are inaccessible. This requirement was not met as evidenced by:
	8 9 10 11 12 13 14	Based on observation licensee did not ensure hazardous items were inaccessible due to the ages of children in care. Due to no children being in care today, this poses a potential Health, Safety or Personal Rights 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: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise Gibbs	TELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2020

LIC809 (FAS) - (06/04)

Page: 5 of 5