192009668-6-27-2019-30-CC-JCHR-BDJSMC-20190627135944

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192009668
Report Date: 06/27/2019
Date Signed: 06/27/2019 02:00:03 PM

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:	POTTS FAMILY CHILD CARE		FACILITY NUMBER:	192009668
ADMINISTRATOR:	POTTS, RALAINA VONETTE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 920-6352
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90303 0
CAPACITY:	14	CENSUS: 12	DATE:	06/27/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	12:57 PM
MET WITH:	Licensee		TIME COMPLETED:	02:00 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 6/27/2019 Licensing Program Analyst, Jillinda Chandler conducted an unannounced annual random visit for Potts family child care. Present in the home was licensee, licensee assistant/sister and 12. The home was inspected inside and out for health and safety compliance per Title 22. Day care is conducted in the living room and dining room. The out doors area was inspected for safety, LPA observed age appropriate toys and equipment. LPA observed the following: Care and supervision were observed The homes capacity was within the scope of the license Appropriate size fire extinguisher carbon and smoke detector present & operable. Detergents, and knives were inaccessible, Toxins were locked and inaccessible. No guns or weapons present as stated by the Licensee, no weapons observed by LPA. Properly working telephone License, facility Sketch, Emergency Disaster Plan & Notification of Parent’s Rights Poster and California Safety Seat Law are posted At least one person was current in Pediatric CPR and First Aid Card No bodies of water on the premises Children records available and in good order. Toys, equipment and materials available and in good order Last drill conducted 5/2019 Roster was available and up to date

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

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: POTTS FAMILY CHILD CARE	FACILITY NUMBER: 192009668
	VISIT DATE: 06/27/2019

NARRATIVE

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· Licensee was made aware that state law prohibits baby walkers, bouncy seats, exersaucers and any other items that fall into that category. Licensee was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation.
· .Applicant was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and to never shake a baby to prevent the Shaken Baby Syndrome.
· Applicant was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.
· The "Notification of Parent's Rights" (PUB394) was discussed with the licensee and the licensee was advised that it must be posted in an area of the home accessible to parents.
· Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541; Email Address: childcareadvocatesprogram@dss.ca.gov
· Also, discussed was; Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. Exemption were also discussed
· Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com
· 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

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3067
LICENSING EVALUATOR NAME: Jillinda Chandler	TELEPHONE: (424) 301-3068
LICENSING EVALUATOR SIGNATURE:	DATE: 06/27/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2019

LIC809 (FAS) - (06/04)

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