197405011-5-29-2019-12-CC-IORA-BCMU32-20190529151249

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197405011
Report Date: 05/29/2019
Date Signed: 05/29/2019 03:13:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME:	GREGORY FAMILY CHILD CARE		FACILITY NUMBER:	197405011
ADMINISTRATOR:	MARIANNE GREGORY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(661) 263-2774
CITY:	VALENCIA	STATE: CA	ZIP CODE:	91354
CAPACITY:	14	CENSUS: 11	DATE:	05/29/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:19 PM
MET WITH:	Marianne Gregory		TIME COMPLETED:	03:22 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) Isabel Ortega met with, Marianne Gregory licensee who guided analyst on a tour of the home 1:45 P.M. The purpose for the visit is to conduct a random annual inspection. Present at the facility today is the licensee and her Assistant, Schaefer. During the inspection 11 children were in care at the time, the child were napping and transition to free play/story time. Residing in the home includes: 2 adult which include Licensee and her spouse. Per Licensing Information System (LIS) all adults residing in the home have obtained background clearances. Per LIS, facility annual fees are current. The licensee is operating within proper capacity and ratios. LPA observed licensee to be present at the home and providing adequate care and supervision. This family child care facility is a two-story home 4 bedrooms, 3 bathrooms with kitchen, living room, dining room and garage. The stairs are gated and not accessible to children. Upstairs is completely off is off limits, the laundry room and the garage is off limits to children. The front door is fire clearance standard meeting regulations. Children do not have access to garage maintained locked at all times. The side door is a self latching lock door.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: GREGORY FAMILY CHILD CARE	FACILITY NUMBER: 197405011
	VISIT DATE: 05/29/2019

NARRATIVE

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The home is clean, orderly, comfortable and well ventilated. LPA observed a working smoke detector tested at 2:11 P.M. and carbon monoxide detector (digital). LPA observed 2A10BC fire extinguisher which was service 2018 and meets fire marshal standards. Licensee has land line telephone service in addition to her cell phone service. There are several age appropriate toys and a first aid kit on the premises. Medications stored in locked kitchen cabinets and are in accessible to children. Knives are stored in the off limits kitchen upper cabinet and maintained locked.

Per applicant, there are no firearms or weapons in the home. LPA did not observe any firearms or weapons. There is one fireplace in the living room per Licensee it is kept covered at all times. Home has a wall centralized AC and heater in the dinning room. Pediatric CPR/First Aid expires June 2020.

The parent board is located to the right of the entrance of the home. The following items were posted: Notice of Parent's Rights Poster PUB394; Emergency Disaster Plan LIC610A; Earthquake Preparedness Checklist LIC9148.

The following was discussed with the applicant:

Licensee was advised mandated reporting training for child care must be taken every two years for Licensee and Assistant or any adult assisting in care at the following website www.mandatedreporterca.com.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: GREGORY FAMILY CHILD CARE	FACILITY NUMBER: 197405011
	VISIT DATE: 05/29/2019

NARRATIVE

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LPA reviewed a sample of children's files. LPA discussed mandatory forms for the children’s files and provider’s files; Requirements for fire drills, earthquake drills and documentation for both. Licensee was reminded that 100% supervision is required at all times to children in care. The Licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov. Licensee was made aware that it is her responsibility to know the regulations as well as anyone who assists in providing care. Licensing must have the facility’s phone number at all times; if the phone number is changed, licensing must be notified. Regulation prohibits the smoking in a private residence that is licensed as a family child care home and in those areas of the family day care home where children are present during the hours of operation.

The Licensee was informed that all adults living in or having access to the home are required to have fingerprint clearances with Department of Justice, FBI and Child Abuse Index prior to having contact with children. If the aforementioned is not adhered to, a Civil Penalty of up to $500, per non-cleared adult will be assessed immediately. Please advise your analysis of any person who will be visiting regularly or for longer than #1 week.

The Licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian. An unusual incident must be reported to the department by telephone or fax during the department's normal business hours before the close of the next working day following the occurrence. The Unusual Incident Report LIC624B must also be completed and submitted within 7 days of occurrence.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

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, 1605 EAST PALMDALE BLV, STE A
PALMDALE, CA 93550

FACILITY NAME: GREGORY FAMILY CHILD CARE	FACILITY NUMBER: 197405011
	VISIT DATE: 05/29/2019

NARRATIVE

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The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a Type A violation is cited, a copy of the licensing report must also be posted for 30 days. If these requirements are not met, civil penalties per violation will be assessed. Copies of the reports must be provided to each parent when a Type A violation is cited along with Acknowledgment of Receipt of Licensing Reports LIC 9224.

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

Child Care Advocates:
To sign up for our Quarterly Updates please email the Child Care Advocates at
chilcareadvocatesprogram@dss.ca.gov & (916) 654-1541.

The facility was in compliance per Title 22 regulations, and no deficiencies were cited today.

An exit interview was conducted and a copy of this report was provided to the Licensee Marianne Gregory on this date.

SUPERVISOR'S NAME: Carissa Bell	TELEPHONE: (661) 789-6953
LICENSING EVALUATOR NAME: Isabel Ortega	TELEPHONE: (661) 789-6944
LICENSING EVALUATOR SIGNATURE:	DATE: 05/29/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2019

LIC809 (FAS) - (06/04)

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