197412264-9-19-2019-30-CC-SLRD-BG6NXL-20190919105118

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412264
Report Date: 09/19/2019
Date Signed: 09/19/2019 10:51:30 AM

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:	SHEPARD FAMILY CHILD CARE		FACILITY NUMBER:	197412264
ADMINISTRATOR:	SHEPARD, PHYLLIS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 696-9840
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90047
CAPACITY:	12	CENSUS: 3	DATE:	09/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Phyllis Shepard, Licensee		TIME COMPLETED:	11:10 AM

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 Analysts LPA Sophia Lord-Richard conducted an Annual/Random Inspection on 9/19/2019. LPA met with Phyllis Shepard, Licensee and toured the inside and outside of the property at 8:15 AM. LPA observed the home to be clean, safe, orderly and well ventilated. LPA observed the home to have a Living Room, Dining Room, Kitchen, 2 bedrooms, and 1 bathrooms. The Licensee utilizes the Living Room and second Bedroom area as the day-care. LPA observed age appropriate toys and equipment for the children. At the time of inspection there were 3 children in care. LPA questioned if there were any weapons in the home? The Licensee informed LPA, no weapons are in the home. The kitchen and bathroom areas were inspected for proper storage of chemicals, detergents, cleaning compounds, medications and sharp pointed objects. All items were made inaccessible to children. Kitchen/bathroom drawers were observed for storage of chemicals when children in care. All electrical outlets observed with protective covers. LPA observed operable smoke detectors throughout the home and tested during this inspection. LPA observed operable carbon monoxide detectors throughout the home and tested during this inspection. The home is equipped with 1 (3-A:40-B:C) Fire Extinguisher. The home is equipped with a First Aid kit. Licensee CPR card on file and expires (8/24/2021). Children's files were inventoried and review at the time of inspection. The home was observed with Central Heating/Air. All required Child Care Postings was observed during inspection. LPA inspected the outside area. There are no bodies of water at the home. Licensee has no Pets.

SUPERVISOR'S NAME: Sharalyn Jenkins-Sweeten	TELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sophia Lord-Richard	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

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: SHEPARD FAMILY CHILD CARE	FACILITY NUMBER: 197412264
	VISIT DATE: 09/19/2019

NARRATIVE

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Senate Bill 792: this bill, commencing September 1, 2016, 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.

New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.

Licensee/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.

Update on Incidental Medical Services: Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation to the Department. Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.

Exit interview was conducted, a copy of the report, LIC 9102, and notice of cite visit issued.

SUPERVISOR'S NAME: Sharalyn Jenkins-Sweeten	TELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sophia Lord-Richard	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: SHEPARD FAMILY CHILD CARE	FACILITY NUMBER: 197412264
	VISIT DATE: 09/19/2019

NARRATIVE

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No deficiency was cited.

Items to be provided to LPA:

1. Licensee Shot Records (MMR)

2. Spouse Shot Records ( MMR, Flu)

3. Mandated Reporter Certificate. (Spouse).

Items Provided to LPA:

1. Licensee Shot Records for Flu and Tdap

2. Mandated Reporter Certificate. (Licensee)

3. Spouse Shot Record (Tdap)

The following was discussed with the licensee:

Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills and documentation for both. Role and responsibilities of being a mandated reporter were discussed. 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 their responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA also explained Assembly Bill 1207 California Child Care Workers; Mandated Training Requirement-Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com.

SUPERVISOR'S NAME: Sharalyn Jenkins-Sweeten	TELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Sophia Lord-Richard	TELEPHONE: (424) 301-3060
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

LIC809 (FAS) - (06/04)

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