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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192000986
Report Date: 05/31/2022
Date Signed: 05/31/2022 04:27:11 PM


Document Has Been Signed on 05/31/2022 04:27 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:HARRIS FAMILY CHILD CAREFACILITY NUMBER:
192000986
ADMINISTRATOR:LAVISH HARRISFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 864-9599
CITY:NORWALKSTATE: CAZIP CODE:
90650
CAPACITY:14CENSUS: 5DATE:
05/31/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:19 PM
MET WITH:Licensee Lavish Harris TIME COMPLETED:
04:40 PM
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On 5/31/22 Licensing Program Analyst (LPA) Jeanette Estrada conducted an unannounced required 1 year inspection at the above facility. LPA arrived at the facility at approximately 1:19PM. LPA rang RING doorbell. Licensee informed LPA she was picking up children at the time. LPA waited for Licensee. Licensee arrived at approximately 1:49PM. LPA met with the Licensee Lavish Harris and informed her of the purpose for the visit. Licensee guided LPA on a tour of the facility. There were 5 children present when LPA arrived. Criminal record clearance for all adults present was verified. Licensee provides care to children ages birth to 13 years old and operation days/ hours are Monday through Saturday 7AM to 5:00PM.
This is a two story, four bedroom, two and half bathroom home with a living room, den, dining room area, kitchen, attached garage, fenced backyard. Areas on limits to children are the living room, den, half bathroom, dining area, kitchen, a day care room next to the garage and fenced backyard. Areas off limits to children are entire upstairs area including four bedrooms and two bathrooms. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 4/8/22. Licensee had a copy of the Roster available during the inspection. There is an operable carbon monoxide detector and a smoke detector in the home. The 2A10BC Fire extinguishers indicated fully charged and were last serviced on 08/2021. There is one in the play room and one on the wall by the kitchen and one in the day care room. The home maintains telephone service (cell phone). Food is provided by Licensee. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. The home is observed to be clean and orderly. There are toys and other age appropriate materials available for children. LPA observed the stairs barricaded by a safety gate. LPA also observed a pet dog in the home. Pet dog was observed behind the safety gate.
Sharp objects, detergents and cleaning compounds are inaccessible to children in care. Sharp objects are kept in an upper cabinet in the kitchen inaccessible to children in care.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:
DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/31/2022
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 4


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: HARRIS FAMILY CHILD CARE
FACILITY NUMBER: 192000986
VISIT DATE: 05/31/2022
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Cleaning products are kept in the garage. Per Licensee there are no medications in the home and there are no children enrolled who require medication. Per Licensee medication will be kept in an upper cabinet in the kitchen. There is central air/ heating in the home. LPA did not observe any wall heaters or fireplaces in the home. LPA observed age appropriate toys and materials in the day care room. Children have meals in the kitchen/dining room area. Children use the restroom next to the garage and kitchen. Per Licensee, children are supervised while playing outside.
Per Licensee, there are no poisons in the home. Licensee understands that all poisons must be locked, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the living room or dining room, per Licensee wherever the child can be supervised. Per Licensee, there are no firearms or weapons stored in the home. LPA did not observe pools or spas, or other bodies of water.
Infant Care: Currently licensee does not have any infants enrolled. Napping equipment should not block entrances or exits. Infant mattresses should be firm with tightly fitted sheets. LPA discussed that each infant enrolled must have their own crib/ napping mat and bedding. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, will provide PIN 20-24-CCP.
Overnight Care: There is no overnight care provided at the moment. LPA discussed the following: Licensee is aware that they must remain wake while children are awake. If children sleep in separate area from licensee, the door must remain open. If licensee cannot hear children when they wake up, video or audio device can be used.
Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights.
At the time of the inspection, there were no staff other than the Licensee present. Per Licensee there are two assistants who are present at times. LPA advised Staff records to contain the following: Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement of Child and Mandated Reporter Training Certificate. Licensee's Pediatric CPR/First Aid expires on 10/28/23 . Licensee has a current flu declination on file.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
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: HARRIS FAMILY CHILD CARE
FACILITY NUMBER: 192000986
VISIT DATE: 05/31/2022
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During inspection the children present was observed to be treated with dignity and respect, observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.
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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm 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 athttps://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.
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.
No deficiencies are being cited today. Exit interview conducted and report was reviewed with the Licensee Lavish Harris. A notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3828
LICENSING EVALUATOR NAME: Jeanette EstradaTELEPHONE: (323) 229-6521
LICENSING EVALUATOR SIGNATURE:

DATE: 05/31/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022
LIC809 (FAS) - (06/04)
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