192001838-4-20-2023-54-CC-KCHE-CR3T7S-20230420142911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192001838
Report Date: 04/20/2023
Date Signed: 04/20/2023 02:29:48 PM

Document Has Been Signed on 04/20/2023 02:29 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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	HEFFERNAN FAMILY CHILD CARE		FACILITY NUMBER:	192001838
ADMINISTRATOR:	HEFFERNAN, NORMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 632-3156
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	14	CENSUS: 4	DATE:	04/20/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:10 PM
MET WITH:	Norma Heffernan, Licensee		TIME COMPLETED:	02:45 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 04/20/2023 at 12:10 PM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and initially met with Licensee's Assistant, A1, and granted entry to facility. Adults in the home were discussed and all have criminal record clearance. Licensee, Norman Heffernan, arrived at 12:30 PM. There were two infants and two preschoolers present, totaling four day care children present during today’s inspection. Licensee states that there are currently 14 children enrolled. The children's roster was reviewed and is current. Required postings were observed. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 02/03/2023. LPA singularly toured the facility both indoors and outdoors. This is a single-story home which consists of three bedrooms and 2.5 bathrooms, Kitchen with Dining area, Living Room, and detached garage converted to living quarters. Areas used by the children include the Living Room (located upon entry of the home), Bathroom 1 (located through doors to the right of Living Room), and Kitchen with Dining Area (located to the rear of the home). Per Licensee, areas off limits to children and parents include all three bedrooms and Bathroom 2 located inside bedroom. LPA observed that there are doors blocking access to off limits rooms that LPA observed to be locked during inspection. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed ceiling fans through out and AC wall unit available. At 12:12 PM, LPA observed a wall heater in Living Room that is barricaded making it off limits. There is a working telephone maintained in the home. At 12:10 PM, LPA observed Living Room to have couch, recliner chair, and television hanging. LPA observed a pack-n-play in Living Room. LPA observed age appropriate toys, free of loose and sharp parts available for children. Licensee states they provide food to children in care and use Living Room for eating, LPA also observed high Report continues- Page 1 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HEFFERNAN FAMILY CHILD CARE	FACILITY NUMBER: 192001838
	VISIT DATE: 04/20/2023

NARRATIVE

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chairs in Living Room and Kitchen area. At 12:13 PM, LPA observed Kitchen with Dining area and a twin size bed. Licensee states this area is provided for children to rest after school and isolation area for sick children. LPA observed all under cabinet sinks in Kitchen to be free of hazards at time of inspection. At 12:34 PM, LPA observed Bathroom 1 to have operable toilet and sink, adequate hand washing and toileting supplies, and general area safety and sanitation at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. At 12:40 PM, LPA observed these items stored in a large cabinet in backyard with a lock at time of inspection. The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

Per Licensee, the children will have access to backyard area for outdoor play which is accessible through backdoor in Kitchen. At 12:21 PM, LPA observed backyard has grass and adequate perimeter fencing through-out the yard. LPA observed detached garage which is converted bedroom, LPA discussed ensuring this are to be off limits. LPA observed another unit in the back which LPA observed to be locked, Licensee states this area is additional storage. LPA observed child size tables and bins with age appropriate toys available for children. LPA observed a play structure on top of sand area that is multi-level with climbing equipment, slide, and swings well maintained at time of inspection. LPA observed half bathroom available for children outside. LPA observed all trees, shrubs, and plants are maintained. LPA observed areas of backyard that are blocked off with white picket fencing, Licensee states these areas are off limits to children.

Licensee states she has four dogs that are kept separate from children at all times. LPA observed dogs to be kept separate from children and dog run in backyard with wood door and lock. LPA heard dogs during inspection.

At 12:20 PM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 05/01/2022. LPA tested dual smoke and carbon monoxide detectors and observed to be in operable condition at time of inspection. LPA observed First Aid kit kept in Living Room. The Licensee has current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensee has taken the Mandated Reporter Training
—CPR Card valid until: 02/11/2025
—Mandated Reporter AB1207 Completed: 03/28/2022

Report Continues - Page 2 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: HEFFERNAN FAMILY CHILD CARE	FACILITY NUMBER: 192001838
	VISIT DATE: 04/20/2023

NARRATIVE

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Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA did not observe any of these items today.

The following were discussed:
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

Licensee (or facility representative) 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.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

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.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited today.

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 was conducted and report was reviewed with the Licensee, Norma Heffernan.
Report Ends - Page 3 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 04/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2023

LIC809 (FAS) - (06/04)

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