192011026-7-24-2019-30-CC-VWHY-BEDRS3-20190724131604

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 192011026
Report Date: 07/19/2019
Date Signed: 07/24/2019 01:16:09 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:	MOBLEY FAMILY CHILD CARE		FACILITY NUMBER:	192011026
ADMINISTRATOR:	MOBLEY, LA RHONDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 538-4677
CITY:	GARDENA	STATE: CA	ZIP CODE:	90249
CAPACITY:	14	CENSUS: 0	DATE:	07/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	03:40 PM
MET WITH:	Mrrs. Mobley		TIME COMPLETED:	05:45 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	Licensing Program Analyst, V. Wheatley conducted a Annual inspection and met with licensee at 3:50PM. LPA did not observe any children on the premises. The licensee's own minor children are present. The home is clean and orderly. LPA inspected the areas of the day care which are the living room, kitchen and family room. The bedrooms are off-limits. LPA observed a charged fire extinguisher, smoke detector, carbon monoxide detector, and working telephone. All electrical outlets, detergents, cleaning supplies and medications are inaccessible to children. The home has central heating and air condition. LPA observed a fireplace inaccessible. There is a first aid kit, age appropriate toys and cots for napping. Licensee has current CPR, first aid, health and safety which expires July 2020. Per the licensee, there are no firearms on the premises. The children are allowed to play in the backyard with no grass. LPA observed age appropriate toys. There are no pets on the premises. There are no bodies of water on the premises. Licensee may take the children to the park with parent's authorization. Licensee states there are no children receiving Incidental Medical Services. Licensee was informed to submit a Operation Plan if children receive these services.

SUPERVISOR'S NAME: Sharon Greene	TELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

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: MOBLEY FAMILY CHILD CARE	FACILITY NUMBER: 192011026
	VISIT DATE: 07/19/2019

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The licensee was reminded that all adults 18 and over living or working in the home and visiting on a frequent basis must be fingerprint cleared prior to being on the premises. A civil penalty will be assessed if this regulation is violated.

LPA reviewed children's records at which are complete .Immunization.records are to be obtained from parent's prior to a child being left with provider. Immunization records shall be kept on blue cards from the local health department. Title 22 Regulations, child care updates viewed at www.ccld.ca.gov. The licensee has required immunizations and has completed Mandated Reporter Training.

LPA discussed discipline policies, personal rights, civil penalties and appeal rights. LPA informed licensee of regulations regarding reporting unusual incidents and injuries within 24 hours.

Licensee was informed that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome). No smoking is allowed on a day care premises. Never shake a baby to prevent Shaken Baby Syndrome. Only children eating may be in high chairs. Provider is required to wash hands after every diaper change. LPA did not observe any baby walkers, exersaucers or bouncers.

The parent board has all the required forms posted.

LPA did not observe any violations according to Title 22 Regulations.

Exit interview.

SUPERVISOR'S NAME: Sharon Greene	TELEPHONE: (424) 302-3048
LICENSING EVALUATOR NAME: Veronica Wheatley	TELEPHONE: (424) 301-3051
LICENSING EVALUATOR SIGNATURE:	DATE: 07/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2019

LIC809 (FAS) - (06/04)

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