197414131-12-12-2019-30-CC-SPOL-BJT3AM-20191212170459

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197414131
Report Date: 12/12/2019
Date Signed: 12/12/2019 05:05:22 PM

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:	WHITE FAMILY CHILD CARE		FACILITY NUMBER:	197414131
ADMINISTRATOR:	WHITE, BRENDA F.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 779-2342
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	12	CENSUS: 8	DATE:	12/12/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	02:50 PM
MET WITH:	Brenda White, Licensee		TIME COMPLETED:	05:30 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) Shandra Powell conducted an unannounced Annual/Required inspection to the above facility. LPA met with Brenda White Licensee who guided analyst on a tour of the facility. Also present during this inspection, is Monica Lara, Licensee’s Assistant. The licensee states that she currently has 12 children enrolled. A current children’s roster is available. LPA observed 2 infants and 6 preschoolers during inspection. This is a one-story home which consists of 2 bedrooms, 2 bathrooms, kitchen, dining room, living room, family room and office space, front yard and backyard (fenced). The children use the bathroom in the hallway. Per licensee, areas off limits to children and parents include: 2 bedrooms, one bath room, kitchen, living room and dinning room. The licensee provides food for children in care. The licensee states that 2 adults and 0 children currently live in the home. Licensee states that she currently has one assistant. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. All areas identified on the facility sketch that children use, were inspected for safety, comfort, cleanliness, telephone service, ventilation is not central and heating is (central). The following was observed and reviewed during this inspection.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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: WHITE FAMILY CHILD CARE	FACILITY NUMBER: 197414131
	VISIT DATE: 12/12/2019

NARRATIVE

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PHYSICAL PLANT
Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock.

LPA observed two fire extinguisher the valve on one of the required 2A 10BC fire extinguisher indicates not fully charged and the other fire extinguisher has a tag that stated was last serviced in 2016. This poses a potential health and safety risk to children in care. During inspection licensee son brought in a new fire extinguisher in the box and LPA observed receipt. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke and carbon monoxide detectors were tested and are operable.

The home is observed to be clean and orderly. There is heating and ventilation for safety and comfort. There is a child safety gate which keeps kitchen and other off limit areas inaccessible to children. There are toys available for children.

The licensee states that there is a land line on the premises.

The outdoor play area was observed to be fenced. At this time, children are using the back yard for outdoor play time. The licensee states that supervision is provided at all times.

The licensee is observed to be operating within the license capacity limitations.

The licensee and other personnel stated they have completed training on preventive health practices including Pediatric First Aid and CPR. However, assistant did not have proof of completion during inspection. This poses a potential health and safety risk to children in care. The licensee's Pediatric First Aid and CPR expires on 08/17/21. There are first aid supplies available.

Children’s records were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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: WHITE FAMILY CHILD CARE	FACILITY NUMBER: 197414131
	VISIT DATE: 12/12/2019

NARRATIVE

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H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and assistant does not have proof of immunization against influenza, pertussis, and measles. Assistant does not have proof of TB results. This poses a potential health and safety risk to children in care.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

The following items were also discussed with licensee during this inspection.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 11/15/19.

PETS: There are no pets on the premises.
POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted.
PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

Infant Care: Licensee states that she is currently caring for infants. LPA advised the licensee to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room.
The licensee stated the following as a supervision plan for infants: Licensee states that infants sleep in the family room/Daycare room.

LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

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: WHITE FAMILY CHILD CARE	FACILITY NUMBER: 197414131
	VISIT DATE: 12/12/2019

NARRATIVE

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Mandated Reporter: Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com

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. 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
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.

LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices.
Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Brenda White, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: WHITE FAMILY CHILD CARE	FACILITY NUMBER: 197414131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/12/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 12/16/2019 Section Cited	1 2 3 4 5 6 7	Employees or volunteers at day care center; immunization requirements; records; exemptions The day care center shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel
	8 9 10 11 12 13 14	record that is maintained by the day care center. This requirement is not met as evidenced by LPAs observing that the Licensee does not have proof of immunization against measles, pertussis, and influenza. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
Type B 12/16/2019 Section Cited	1 2 3 4 5 6 7	On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child 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 mandated reporter training every two years following
	8 9 10 11 12 13 14	the date on which he or she completed the mandated reporter training. This requirement has not been met as evidenced by LPA staff file reviews and licensee's assistant Monica Lara did not complete the training at this time. This poses a potential risk to the health and safety of children in care.	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: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2019

LIC809 (FAS) - (06/04)

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