197411017-2-23-2022-54-CC-AMOY-CBX2KC-20220223162742

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197411017
Report Date: 02/23/2022
Date Signed: 02/23/2022 04:28:01 PM

Document Has Been Signed on 02/23/2022 04:28 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	WILSON FAMILY CHILD CARE		FACILITY NUMBER:	197411017
ADMINISTRATOR:	WILSON, DARLENEC.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 293-5841
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90062
CAPACITY:	12	CENSUS: 5	DATE:	02/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Darlene Wilson, Licensee		TIME COMPLETED:	04:45 PM

NARRATIVE

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Licensing Program Analyst (LPA) Alicia Mooberry conducted a Required Annual Inspection on this date. LPA met with Darlene Wilson, Licensee. LPA explained the purpose of the inspection and provided and explained the inspection Entrance Checklist, LIC 126. Licensee provided tour of facility.

LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the hours of operation are Monday-Friday 6:00am-6:00am - not to exceed 24 hours of care at a time. There were 5 children present. Also present was Maurice Roberts, assistant. Individuals residing on the home were discussed and noted. All adults present have received background clearance.

The facility is a two-story home consisting of three bedroom, two bathroom with detached garage, front and backyard. The licensee stated that no child care is being conducted in the detached garage.

Off limit areas include: three (3) bedrooms and one (1) bathroom located upstairs and it is made inaccessible by child proof gate at the bottom of the stairs.

The areas for childcare is being conducted in the living room (activity and sleeping room), the kitchen, one bathroom (located downstairs), front and backyard. Telephone service, heating, lighting and ventilation were evaluated and in good condition. No fireplace or open face heaters observed during the inspection. Furniture and equipment was inspected for age appropriateness and good repair.

LPA observed required posted documentation in facility entrance which included: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA observed completed facility records including; LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan.

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged and was serviced in 2017, Page 1 – Report Continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022

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

FACILITY NAME: WILSON FAMILY CHILD CARE	FACILITY NUMBER: 197411017
	VISIT DATE: 02/23/2022

NARRATIVE

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Licensee was reminded that fire extinguisher needs to be serviced yearly. This poses a potential risk to the health and safety of children in care. The home maintains telephone service. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children. LPA observed that detergents, cleaning compounds are in the kitchen and bathroom in cabinets with safety latches inaccessible to children. LPA observed poisons stored in the detached garage in locked cabinet. Per Licensee there are no firearms or weapons stored in the home. There are no pools, spas or other bodies of water on the premises.

Isolation area for sick children waiting to be picked up is in den, away from the other children.

The bathroom that children use is located in the den by the kitchen and observed to be clean and free of hazards.

Currently, children are using the front yard and back yard for outdoor play, both areas observed to be fenced. LPA observed that the outdoor areas have toys and other materials for children to play with. LPA did not observe any objects that could be hazardous to children in care. The door the detached garage is locked. Licensee has no infants currently enrolled. LPA provided PIN 20-24-CCP and LIC 9227 for when/if infants are enrolled.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, and documentation of 15-minute Infant Sleep Check (0-24 months)

Staff records were reviewed for approved Pediatric First Aid and CPR certification, LIC-501: Personnel Record, LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate.

LPA observed that the Mandated Reporter Certificate was not available for licensee and staff. LPA provided licensee with the Mandated Reporting training website at www.mandatedreporterca.com for licensee and staff to complete. During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment.

-------------------Page 2 – Report Continues

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

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

FACILITY NAME: WILSON FAMILY CHILD CARE	FACILITY NUMBER: 197411017
	VISIT DATE: 02/23/2022

NARRATIVE

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LPA observed that licensee is implementing COVID-19 precautions and procedures.

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

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/inspection-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.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Darlene Wilson. Appeal Rights were discussed and provided. - End of Report

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia Mooberry	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 02/23/2022 04:28 PM - It Cannot Be Edited

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: WILSON FAMILY CHILD CARE	FACILITY NUMBER: 197411017
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/23/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based onLPA observations, the licensee did not comply with the section cited above in that the Fire Extinguisher has not been serviced yearly-Last serviced on 3/23/17 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/02/2022
	Plan of Correction
1 2 3 4	Licensee will purchase a new fire exitngusher and provide a copy of the reciept by the POC due date.

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record reviews, the licensee did not comply with the section cited above in 2 out of 2 records reviewed (licensee and Staff did not have the Mandated reporter training certificate, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/02/2022
	Plan of Correction
1 2 3 4	Licensee stated they and staff will complete the mandated reporter training certificate and provide proof to LPA by POC due date.

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: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

LIC809 (FAS) - (06/04)

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