197417263-3-9-2023-30-CC-SPOL-CPRV3W-20230309150524

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417263
Report Date: 03/09/2023
Date Signed: 03/09/2023 03:48:36 PM

Document Has Been Signed on 03/09/2023 03:48 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:	MORAN FAMILY CHILD CARE		FACILITY NUMBER:	197417263
ADMINISTRATOR:	MORAN, WENDY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 399-8712
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	14	CENSUS: 13	DATE:	03/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:33 AM
MET WITH:	Luz Castillo, Assistant and Wendyn Moran, Licensee		TIME COMPLETED:	03:17 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 inspection on 03/09/2023. A Risk Assessment for COVID-19 was completed before entry. LPA met with Luz Castillo, Assistant and Genaro Garcia, Assistant. The licensee was not present during initial start of inspection. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided to the staff upon entry. The facility operating hours/days are 7 days a week and 24 hours a day. This is a one two story home. Per Licensee one other adult reside in the Family Child Care Home. All Adults present, residing and working in the home are fingerprint cleared and associated to the facility. LPA observed 13 napping children with 3 of whom were infants. Assistant Luz, guided analyst on a tour of the facility. LPA observed Facility License and Notification of Parents Rights posted on wall in the living room area behind the front door. LPA reviewed the Emergency Disaster Plan LIC610A, Disaster and Fire Drill Log and Facility Roster LIC 9040. The home is a two story home with 7 bedrooms 4 off limits used as family living areas 2 on limits, used for napping and day care areas, and 1 off limits used as licensee’s office made inaccessible by padlock. 3 bathrooms 1 on limits, 2 off limits. Living and Dining Room have a open concept with the kitchen, Front yard (off limits) Back yard (on limits.) The day-care is located at the front of the home and the living quarters for the family is located on the added addition of the two story home which is inaccessible to children in care by padlock on door leading to the second part of the home.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 6

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: MORAN FAMILY CHILD CARE	FACILITY NUMBER: 197417263
	VISIT DATE: 03/09/2023

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
26
27
28
29
30
31
32

The children eat, nap and play in the day care room areas. LPA observed the kitchen was accessible during child care hours. LPA observed child proof locks on kitchen cabinet. LPA reminded licensee when children bring food or drink items into the home during childcare hours they must be labeled and properly stored.

The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. Home utilizes central heating and air for a cooling and heating source. Home has a working telephone. Hazardous materials in the kitchen and bathroom are inaccessible to children. LPA inspected children bathroom no hazardous materials were observed. According to the Licensee, there are no weapons or firearms at the home; None were observed by LPA. Per Licensee, there are one pet dog. LPA observed the dog gated on the side of home.

LPA observed a fire extinguisher which is at least a 2A:10BC, the extinguisher will be due for service in June 2023. The home is also equipped with a working smoke detector and carbon monoxide detector which was tested during inspection. There is also a first aid kit equipped in the home. LPA did observed a current First Aid/ CPR certificate for Licensee with a expiration date of 03/2025. LPA observed the required Mandated Reporter training certification completed October 2022.

LPA observed age-appropriate toys and playthings for children to play with during inspection.. Licensee agrees that no baby-walkers, bouncers, jumpers, exersaucers and similar items will not be used for children in care and are kept inaccessible; None were observed by LPA.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

Page: 2 of 6

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: MORAN FAMILY CHILD CARE	FACILITY NUMBER: 197417263
	VISIT DATE: 03/09/2023

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
26
27
28
29
30
31
32

Per licensee the outside play for the children is conducted in the back yard of the home. LPA observed a large tented space with children toys, tables and bikes for children to play located in the back yard. LPA observed a shed in the backyard used to store supplies. The outdoor play area is fenced in. Per Licensee, supervision of the children is provided at all times by Licensee and or staff during outside play time. During inspection No pools, spas, hot tubs, fish ponds, or similar bodies of waters observed during the inspection.

LPA reviewed children's file during today's inspection and observed the following LIC 700 (Identification and Emergency Information), LIC 627 (Consent for Emergency Medical Treatment), LIC 995A (Notification of Parents' Rights). LPA did not observe Children's Records: Immunization Records this is a potential Health and Safety Risk to children in care.

LPA reviewed staff files during inspection. Staff files were complete.

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.

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 Carrying out medical orders when the child’s physician has determined that a layperson can be trained and safely carry out the orders.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

Page: 3 of 6

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: MORAN FAMILY CHILD CARE	FACILITY NUMBER: 197417263
	VISIT DATE: 03/09/2023

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
26
27
28
29
30
31
32

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. Licensee subscribed to receive Important updates during inspection.

U.S. CONSUMER PRODUCT SAFETY COMMISSION FISHER-PRICE INFANT EQUIPMENT RECALLS: PIN 20-19 advise licensee to print PIN to review
During this inspection, LPA also provided the following documents about SIDS. 1) A Child Care Provider’s Guide to Safe Sleep by the American Academy of Pediatrics, 2) Safe Sleep for Your Baby by the U.S. Department of Health and Human Services.

The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000. Also call the CCL office within 24 hours of the Unusual Incident and follow up with a written Unusual Incident/Injury Report (LIC 624B) within 7 business days.

Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome) and that the Provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome

LPA provided Safe Sleep Practices: always place infants on their backs for sleeping; use only a tight-fitting sheet on the crib or play yard mattress; do not hang any items from the crib or above the crib; keep all items, including blankets, out of the crib or play yard; pacifiers may be used as long as they do not have items attached to them; infants should not be swaddled or have any items covering them while sleeping; the temperature of the room should be comfortable enough for an adult to wear a t-shirt and not be too hot or too cold.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: MORAN FAMILY CHILD CARE	FACILITY NUMBER: 197417263
	VISIT DATE: 03/09/2023

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
26
27
28
29
30
31
32

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 experienced. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding inspection tools and methods, please visit the Program website at www.cdss.gov/inforesouces/community-care-liceinsing/inspection-process .

Exit interview conducted and report was reviewed with the Licensee. Report, Appeal Rights and Notice of Site Visit were given to Licensee. The Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6