192003036-10-13-2021-33-CC-JGUN-C7RVB6-20211013161703

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192003036
Report Date: 10/13/2021
Date Signed: 10/13/2021 04:17:11 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	ROBINSON FAMILY CHILD CARE		FACILITY NUMBER:	192003036
ADMINISTRATOR:	ROBINSON, MARY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 919-1296
CITY:	LA PUENTE	STATE: CA	ZIP CODE:	91744
CAPACITY:	14	CENSUS: 11	DATE:	10/13/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:09 PM
MET WITH:	Mary Robinson, Licensee		TIME COMPLETED:	04:20 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 Analyst (LPA) Jose Guzman conducted an unannounced required inspection. A risk assessment was conducted prior to entering the facility. LPA met with Licensee, Mary Robinson, during today’s inspection. Also present were licensee's assistant, daughter, and contractor. There were 11 children present. Licensee states that there are currently 12 children enrolled. The children's roster was reviewed and is current. Disaster drill log was also available during today’s inspection. This is a one-story home which consists of 2 bedrooms and 2 bathrooms. Areas used by the children include the family room, living room 1 bathroom, front yard, and back yard (Off limits until construction work is complete). Per licensee, areas off limits to children and parents include 2 bedrooms, 1 bathroom, dining area, kitchen, and converted garage. Rooms that are off-limits need to be made inaccessible during operating hours. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Family members residing in the home are 2 adults (criminal record clearances on file). There is a working telephone maintained in the home. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. The licensee does understand that poison must be locked with a key or combination lock. At 1:26pm LPA observed a contractor working on a construction project. Per licensee, construction project will be complete in two weeks. Licensee informed Department of construction project on 08/16/21 at 2:35pm. Per licensee, there are no weapons, firearms or bodies of water on the premises. There are safe toys, play equipment and materials observed for children. Emergency Disaster Plan was posted at the time of inspection. Page 1 of 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ROBINSON FAMILY CHILD CARE	FACILITY NUMBER: 192003036
	VISIT DATE: 10/13/2021

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’s records were reviewed to ensure that each child has an Identification and Emergency form. Licensee understands that fire extinguishers need to be serviced yearly or a new fire extinguisher can be purchased. A smoke detector and carbon monoxide detector were tested and are in operable condition. The licensee and assistant have a current Pediatric First Aid and CPR, which will expire 01/2023.
Proof of immunization against influenza, pertussis, and measles for the licensee and assistant were readily available during today’s inspection. The licensee and assistant have taken the Mandated Reporter Training.

The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep web page 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.

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 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.
Page 2 of 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: ROBINSON FAMILY CHILD CARE	FACILITY NUMBER: 192003036
	VISIT DATE: 10/13/2021

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	A notice of site visit was given and must remain posted for 30 days. At this time, the licensee is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today. Exit interview was conducted with Licensee, Mary Robinson. Page 3 of 3

SUPERVISOR'S NAME: Ana Chico	TELEPHONE: (323) 981-3374
LICENSING EVALUATOR NAME: Jose Guzman	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3