197412264-1-23-2023-30-CC-ARIR-CNCQJ4-20230123111208

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197412264
Report Date: 01/23/2023
Date Signed: 01/23/2023 11:12:19 AM

Document Has Been Signed on 01/23/2023 11:12 AM - 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, 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:	01/23/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Phyllis Shepard, Licensee		TIME COMPLETED:	11:15 AM

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On 1/23/2023, Licensing Program Analyst (LPA) Adrian Risher conducted an Annual Inspection. LPA provided Licensee with the purpose of the visit and was granted access to the facility. LPA met with Phyllis Shepard, Licensee. LPA toured the inside and outside of the property with the Licensee. LPA observed the home to be clean, safe, orderly and well ventilated. There were 4 children present at the time of inspection. The operating hours are Monday thru Friday 7:00am to 6:00pm.

LPA observed the home to have a Living Room, Dining Room, Kitchen, 3 bedrooms, and 1 bathroom. The Licensee utilizes the one bedroom and the living room areas as the day-care. The rest of the home is inaccessible to the children. Licensee stated the bedroom is used for daily activities. The living room is used for daily activities and napping. The children eat in the kitchen. The children use mats for naptime.

LPA observed age appropriate toys and equipment for the children. Licensee states that there are no weapons in the home. Licensee reports that there are no pets in the home. The kitchen and bathroom areas were inspected for proper storage of chemicals, detergents, cleaning compounds, medications and sharp pointed objects. These items were made inaccessible to children.

LPA inspected the outside play area and observed age appropriate toys. There are no bodies of water at the home. The outside play are is gated all around.

LPA observed operable smoke detectors and carbon monoxide detectors throughout the home which were tested during inspection. The home is equipped with 1 (2-A:10-B:C) Fire Extinguisher and First Aid kit which includes thermometer and band aids. The home has central air and heat.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian Risher	TELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

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: 01/23/2023

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Staff and children files were reviewed during the inspection and found to be complete. Licensee CPR card expires 08/2023. LPA reviewed records related to earthquake drills and fire drills which were found to be current. All required Child Care Postings was observed on the Parent Board during inspection.

No deficiencies were observed during the inspection.

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/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.

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

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Phyllis Shepard

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Adrian Risher	TELEPHONE: (424) 301-3050
LICENSING EVALUATOR SIGNATURE:	DATE: 01/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2023

LIC809 (FAS) - (06/04)

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