197417526-10-9-2019-30-CC-HESA-BGSPRE-20191009113236

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197417526
Report Date: 10/09/2019
Date Signed: 10/09/2019 11:32:48 AM

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:	BETTES FAMILY CHILD CARE		FACILITY NUMBER:	197417526
ADMINISTRATOR:	BETTES, TIMOTHY G.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 374-8284
CITY:	HERMOSA BEACH	STATE: CA	ZIP CODE:	90254
CAPACITY:	14	CENSUS: 6	DATE:	10/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Timothy Bettes - Licensee		TIME COMPLETED:	11:45 AM

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	On 10/9/19 at 10:30 AM, Licensing Program Analyst (LPA) Helen Estrella arrived 554 24th Street Hermosa Beach CA 90254 for the purpose of an annual/random inspection. Upon arrival, LPA met with the licensee Timothy Bettes and informed the nature of the visit. LPA confirmed with the licensee that all adults in the home have obtained a criminal record/TB clearance and are associated to the facility. LPA was guided on a tour of the home (inside and outside). The facility is one story home that consist of 3 bedrooms, 2 bathrooms, den, and back yard. Main care is conducted in the den/family room and room #1 that is adjacent to the rear family room for napping. The other accessible areas of the home are backyard and bathroom #1. The off limits areas are: entire home and licensee's bedroom. LPA observed the following during the inspection: age appropriate toys and equipment, current Pediatric CPR/First Aid valid through 7/2021, equipped first aid kit, and fully charged 2A10BC fire extinguisher in the home. There are smoke/carbon monoxide detectors in operable condition. The home appears neat, clean and well ventilated. The home has a fire place that was observe with a barricade. The licensee does not have weapons/firearms in the home and none observed by LPA. LPA inspected outdoor area and observed fenced in. There are no bodies of water on the property. There were 6 children present with the licensee and 2 assistants. Children's records were reviewed and appeared complete with required licensing documents. The facility is operating within its capacity limitations. Page 1

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

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: BETTES FAMILY CHILD CARE	FACILITY NUMBER: 197417526
	VISIT DATE: 10/09/2019

NARRATIVE

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At this time, the licensee does not provide Incidental Medical Services (IMS). Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted 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.

The following was discussed with the licensee:
All adults living and working in the home must be fingerprinted and cleared prior to entering the facility. The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. Phone number: (916) 654-1541. childcareadvocatesprogram@dss.ca.gov.

Mandated Reporter Training: 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. The OCAP modules are free of cost and available at: http://www.mandatedreporterca.com/.

Licensee informed Fire disaster drills are to be conducted at least once every 6 months and log must be kept. Licensee also informed children records and facility roster must be kept for 3 years and advised all public reports must be kept for review. Forms and Regulations available at: www.ccld.ca.gov. Licensee is informed of appeal rights, and an appeal must be submitted in writing within 15 business days from date of receiving penalty assessment to the Department.

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SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

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: BETTES FAMILY CHILD CARE	FACILITY NUMBER: 197417526
	VISIT DATE: 10/09/2019

NARRATIVE

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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 made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. 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. Licensee was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.

The licensee was advised that, once licensed, the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, (Type A violation), a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. The applicant was made aware that a licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

The licensee was provided an LIC279. He wishes to add a co-licensee. LPA discussed terms and conditions of co-licensee. The licensee states will submit the application when co-licensee is ready to be added.

The facility is operating within substantial compliance during today's inspection. An exit interview conducted and copy of this report provided to the licensee.

SUPERVISOR'S NAME: Jennie Ferreira	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR NAME: Helen Estrella	TELEPHONE: (424) 301-3073
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

LIC809 (FAS) - (06/04)

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