197416865-8-17-2022-30-CC-KSCT-CHE22H-20220817170047

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197416865
Report Date: 08/17/2022
Date Signed: 08/17/2022 05:07:10 PM

Document Has Been Signed on 08/17/2022 05:07 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	REYNOLDS FAMILY CHILD CARE		FACILITY NUMBER:	197416865
ADMINISTRATOR:	REYNOLDS, ELMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 347-1318
CITY:	GARDENA	STATE: CA	ZIP CODE:	90249
CAPACITY:	14	CENSUS: 9	DATE:	08/17/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Elma Reynolds- Licensee		TIME COMPLETED:	05:15 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), Keyona Scott, conducted an unannounced Annual Required inspection on 08/17/2022. LPA met with Licensee, Elma Reynolds at 12:25 PM. LPA observed nine children which includes one (1) infant and two Assistants (A1, A2) present at the family child care home. All Adults present, residing, working and/or volunteering in the home have a criminal record clearance or exemption and are associated to the facility. PHYSICAL PLANT All areas on the facility sketch were identified. This a one-story home with three bedrooms, living room, dining room, kitchen, den, extended den, and detached garage. Per Licensee, no childcare is conducted in the detached garage. One of the three bedrooms has been converted into an office; the other two bedrooms in the home are off-limits and made inaccessible to children in care by closed doors with safety knobs. The kitchen is also off-limits and made inaccessible by safety gate at the kitchen entranceway. The home consist of two classrooms, separated by ages, 18 months to two (2) years old and three years old to Kindergarten. The 18 month to two year old classroom is located at the rear of the home in the extended den. The 3 years old to Kindergarten class is located in the living room at the entrance of the home. The children utilize the bathroom directly in front of the hallway entrance. LPA observed foldable changing table that was attached to the wall in the hallway adjacent to the bathroom. Hours of operation are Monday through Friday, 24 hours. The 18 months to two years old utilize the North wing of the living room to dine during meal and snack time and the three year olds to Kindergarteners utilize the den. Per Licensee, children are served three meals (breakfast, lunch, dinner) and two snacks (morning and afternoon snack). The office is used as an isolation area when children in care become ill, until parents arrive. Per Licensee, child(ren) in isolation area are supervised by an Adult at all times. PAGE 1

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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

FACILITY NAME: REYNOLDS FAMILY CHILD CARE	FACILITY NUMBER: 197416865
	VISIT DATE: 08/17/2022

NARRATIVE

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Outdoor play for the 18 months to two year olds is conducted in the backyard of the home. The outdoor play area for the three year olds to Kindergarten is conducted in the front yard at the entrance of the home. Both outdoor play areas are fully fenced and free of dangerous and hazardous conditions. LPA observed age-appropriate toys in each of the outdoor play areas. LPA advised Licensee that children in care are to be supervised at all times.

The home was inspected for safety, comfort and cleanliness. The home has working telephone service. The telephone number on file with the Department was confirmed and verified. All poisons, to include, detergents, cleaning compounds, medication and other hazardous materials are inaccessible to children in care. There is a fully charged fire extinguisher that is at least a 2A: 10BC in the home. There is at least one working carbon monoxide detector and smoke detector in the home. There is also a first aid kit in the home. Centralized heat, air ventilation system are used as heating and cooling sources. LPA observed safe and age-appropriate toys and play equipment in the home. Per Licensee, there are no weapons, firearms or ammunition in the home. Licensee was informed if obtains, firearms and ammunition must be stored and locked separately.

FACILITY RECORDS

LPA observed Licensee and Assistants current Pediatric CPR and First Aid cards. Licensee's Pediatric CPR and First Aid certification expires on 06/05/2023. LPA observed Mandated Reporter training certificates for Licensee and Assistants; Licensee renewed Mandated Reporter training on 03/11/2022. LPA reminded Licensee that Licensee and staff are to renew Mandated Reporter training every two years online at: www.mandatedreporter.ca .

LPA informed Licensee to have Assistants complete the following forms and include in each staff's individual file: LIC 9052 (Employee Rights), LIC 9108 (Statement Acknowledging Requirement to Report Child Abuse. During today's inspection, Licensee printed both forms and had each Assistant present review and complete the forms and placed in each staff's individual file. LPA observed completed forms prior to the end of the inspection.

LPA reviewed children's files during today's inspection and observed the following Children's Records: Immunization Records, LIC 700 (Identification and Emergency Information), LIC 627 (Consent for Emergency Medical Treatment), LIC 995A (Notification of Parents' Rights) PAGE 2

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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

FACILITY NAME: REYNOLDS FAMILY CHILD CARE	FACILITY NUMBER: 197416865
	VISIT DATE: 08/17/2022

NARRATIVE

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LPA observed the following required posting on Parent Board in childcare room:

Facility License
PUB 394- Notification of Parents' Rights (completed with Department and Complaint Line Information)

LPA provided Licensee with the following required posting to post on parent board:

LIC 9148- Earthquake Preparedness Checklist

LPA reviewed the following documents during today's inspection:

Verification of Disaster Fire Drills: Per LPA review, fire disaster drill was last conducted April 2022.

The following was thoroughly discussed with Licensee:
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.

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SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

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

FACILITY NAME: REYNOLDS FAMILY CHILD CARE	FACILITY NUMBER: 197416865
	VISIT DATE: 08/17/2022

NARRATIVE

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The facility was operating in substantial compliance during today’s inspection on 08/17/2022. Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies were cited.

Exit interview conducted and report was reviewed with the licensee, Elma Reynolds.

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.

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SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Keyona Scott	TELEPHONE: (424) 301-3091
LICENSING EVALUATOR SIGNATURE:	DATE: 08/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022

LIC809 (FAS) - (06/04)

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