197403631-7-27-2021-54-CC-AMOY-C5BV46-20210727160549

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197403631
Report Date: 07/27/2021
Date Signed: 07/27/2021 04:05:58 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	WOODS FAMILY DAY CARE		FACILITY NUMBER:	197403631
ADMINISTRATOR:	LAFREDA WOODS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 291-0704
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY:	14	CENSUS: 4	DATE:	07/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	LaFreda Woods, Licensee		TIME COMPLETED:	04:15 PM

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Licensing Program Analyst (LPA) Alicia Mooberry conducted and unannounced annual inspection. LPA arrived at the facility at 1:45pm and was met by Charles Wood Jr. (Adult 1), a cleared adult. LPA identified herself and provided and stated the purpose of inspection. Mr. Woods Jr. stated licensee was not home and called licensee. LPA asked Adult1 if there were kids in care and he stated he didn't know. At 1:50 pm LPA requested to entry into the facility for the purpose of confirming children in care. Adult 1 denied entry stating that he wanted to wait for his mom licensee. An immediate $500 civil penalty is assessed.

At 1:57 licensee arrived at the facility and informed LPA that there are four (4) children in care and currently at the park being cared for Jackie Small, an uncleared adult. This poses and immediate risk to the health and safety of children in care. A Civil Penalty of $100 is assessed on this date. At 2:01 Licensee left the facility and returned at 2:20pm with 4 children and Jackie Small, Assistant and uncleared adult.

LPA entered facility and reviewed files and children's records. Licensee did not have a roster available.
LPA Mooberry observed deficiencies and citations were issued. Due to time constraint not all deficiencies observed were cited and this inspection will be concluded at a later time.
The Notice of Site Visit (LIC 9213) – must remain posted for 30 dayduring the hours of operation
Deficiencies are being cited in accordance with Title 22 regulations.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit. A copy of the Parent Notification Requirements was also provided to the licensee/Director.

Exit interview was not conducted due to licensee with LaFreda Woods, Licensee. This report along with appeal rights were left at facility door,

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

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

FACILITY NAME: WOODS FAMILY DAY CARE	FACILITY NUMBER: 197403631
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/27/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/27/2021 Section Cited	1 2 3 4 5 6 7	Inspection Authority of Department. Any authorized employee of the Department may enter and inspect any place providing personal care and services at any time, with or without advance notice.- This requirement is not met as evidenced by
	8 9 10 11 12 13 14	Charles Wood Jr.,(licensee's son) did not allow LPA entry into the childcare home, stating "I want to wait for my mom" This poses an immediate risk to the health and safety of children in care. An Immediate $500 Civil Penalty is being assessed	8 9 10 11 12 13 14
Type A 07/27/2021 Section Cited	1 2 3 4 5 6 7	All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility shall obtain a California clearance or a criminal record exemption as required by the Department This requirement is not met as evidence by:
	8 9 10 11 12 13 14	LPA observed uncleared adult Jackie Small providing care. Per licensee, children were left at the park in care of uncleared adult. Per licensee, Ms. Small has been assiting her just today. This pose an immediate risk to the children in care. A civil penalty on $100 is being assessed.	8 9 10 11 12 13 14

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: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2021

LIC809 (FAS) - (06/04)

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