197417201-3-29-2023-30-CC-DADS-CQDVNH-20230329163511

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417201
Report Date: 03/29/2023
Date Signed: 03/29/2023 04:35:25 PM

Document Has Been Signed on 03/29/2023 04:35 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:	HARRELL FAMILY CHILD CARE		FACILITY NUMBER:	197417201
ADMINISTRATOR:	HARRELL, TAMARA L.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 313-2426
CITY:	VENICE	STATE: CA	ZIP CODE:	90291
CAPACITY:	14	CENSUS: 14	DATE:	03/29/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Sheryl Josefson		TIME COMPLETED:	04:45 PM

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On 3/29/2023 Licensing Program Analyst (LPA) Dalicia Adkins, conducted an unannounced Annual Required Inspection and was met by child care assistant Sherly Josefson , licensee Tamara Harrell arrived after LPA arrival. Also present was/were Staff #1 (S1)- Staff #4. Days and hours of operation are Monday- Friday 8:30 am-5:30 pm.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed and Licensee confirmed that the kitchen, bathroom and living room are used for providing care and are accessible to children. All other rooms are off-limits and made inaccessible by use of locked doors. There is no swimming pool or other bodies of water on the premises. There is a There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The fireplace located in the main living area is made inaccessible by a screen and will not be in use during daycare hours. There are no fireplaces or open face heaters in the home.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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: HARRELL FAMILY CHILD CARE	FACILITY NUMBER: 197417201
	VISIT DATE: 03/29/2023

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There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort. There are no stairs in this home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is (310) 313-2426 and cell number (310) 383-1151.

There are currently no infants in care. LPA discussed Safe Sleep Regulations with licensee.

Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The outdoor play area in the backyard is fenced and there are no hazards to children present. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training and CPR expired. Licensee and staff enrolled in Mandated reporting and CPR classes and will send LPA a copy of certification of completion via email by 4/3/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

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: HARRELL FAMILY CHILD CARE	FACILITY NUMBER: 197417201
	VISIT DATE: 03/29/2023

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Incidental Medical Services (IMS) not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.
LPA and Licensee discussed the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

LPA provided technical assistance and advisory given (refer to LIC 9102TA) 1596.8662(b)(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. 102416(c)The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days. Exit interview conducted.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Dalicia Adkins	TELEPHONE: (424) 301-3064
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023

LIC809 (FAS) - (06/04)

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