192007832-7-1-2022-30-CC-JLAO-CFWU7E-20220701151949

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192007832
Report Date: 06/30/2022
Date Signed: 07/01/2022 03:20:49 PM

Document Has Been Signed on 07/01/2022 03:20 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	HOWARD FAMILY CHILD CARE		FACILITY NUMBER:	192007832
ADMINISTRATOR:	HOWARD, ALICE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 447-4239
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90043
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 13	DATE:	06/30/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:			TIME COMPLETED:	03:00 PM

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On 6/30/2022 Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection and was met by Alice Howard.

Days and hours of operation are 6:00 a.m. to 6:00 p.m., Monday through Friday. Facility provides care and supervision to children ages 3 months to 12 years old.

LPA toured the home inside and outside and a census was taken; 12 children, 1 infant and one additional adult were present during the inspection.

Current facility sketch reviewed, and Licensee confirmed that the Living Room, Bedroom 1, Bedroom 3 and bathroom 1 are used for the day care. Bedroom 3 is used primarily for all day care activities and napping occurs in the living room and bedroom 1. The kitchen is used as a walkway to access bedroom 3. The bathroom that children use is bathroom 1 located outside bedroom 1 and the kitchen area.

The following areas are currently OFF LIMITS: Bedroom 2 and bathroom 2. Bathroom 2 is occasionally used when bathroom 1 is not available. LPA observed the doors of bedroom 2 and bathroom 2 closed and locked during the hours of operations. Licensee confirmed that the back yard and detached garage in the back is OFF LIMITS to the children in care. LPA observed a locked gate on both sides of the home.

Fire place located in the living room was observed to be barricaded with a metal gate and barricaded with a file cabinet. An open face heater is located outside bedroom 1 was observed to be barricaded.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible and stored under the kitchen cabinet. Licensee confirmed that most cleaning supplies are kept in the cabinets above the washer and dryer unit located inside bathroom 1. LPA observed cleaning supplies under the closed cabinet under the sink area.

There are two working fire extinguisher, one is located outside the living room area and the

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HOWARD FAMILY CHILD CARE	FACILITY NUMBER: 192007832
	VISIT DATE: 06/30/2022

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second one is located outside bedroom 3. LPA observed a working smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.

Safe toys and play equipment are observed inside and outside of the home. The front enclosed yard was confirmed to be the outdoor area used by the children. The home has a working telephone service and LPA confirmed the phone number is 323-447-4239. Licensee confirmed she currently does not use email.

Licensee confirmed she is available to care for infants. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan will be completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Capacity as specified on the license is being maintained.

LPA observed a small dog in the daycare, Licensee confirmed that a current vaccination record will be email to LPA by 7/14/2022.

LPA reviewed a sample of children’s files and observed files were incomplete. Licensee agrees to have a completed LIC 9227-Individual Infant Sleeping Plan for all infants enrolled in the program. Licensee Mandated Reporter Training was not available for review. Licensee agrees to submit proof of completion to LPA by 7/14/2022. Licensee’s pediatric CPR/First Aid was taken on 7/18/2021. LPA reviewed the LIC311D with licensee

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HOWARD FAMILY CHILD CARE	FACILITY NUMBER: 192007832
	VISIT DATE: 06/30/2022

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and provided a sample packet of all necessary forms.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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.

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 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.

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 conducted and report was reviewed with the licensee Alice Howard.

SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/01/2022 03:20 PM - It Cannot Be Edited

Created By: Judy Laureano On 06/30/2022 at 01:47 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: HOWARD FAMILY CHILD CARE	FACILITY NUMBER: 192007832
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/30/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102416.1(a)

Personnel Records

(a) Personnel records shall be maintained on each employee and shall contain the following information: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and licensee's interview, the licensee did not comply with the section cited above in 1 out of 1 employee's file which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/14/2022
	Plan of Correction
1 2 3 4	Licensee agrees to have a complete file for assistant review for review for CCL by 7/14/2022. LPA provided licensee with necessary forms and LIC311D (2/22) FIle will have Employee Rights, CPR and First Aid, Mandated Reporter Training,

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Claudia Escobedo

LICENSING EVALUATOR NAME:

Judy Laureano

LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022

LIC809 (FAS) - (06/04)

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