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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417533
Report Date: 11/16/2022
Date Signed: 11/16/2022 11:16:00 AM

Document Has Been Signed on 11/16/2022 11:16 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MOCH FAMILY CHILD CAREFACILITY NUMBER:
197417533
ADMINISTRATOR:MOCH, SHARONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 299-8580
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: DATE:
11/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Sharon MochTIME COMPLETED:
11:45 AM
NARRATIVE
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Licensing Program Analyst (LPA) Doris Whitmore conducted an unannounced 3-Year Required Inspection at the facility to ensure that health and safety standards are being met as required by regulations, statutes, and requirements governing California family childcare homes according to Department Regulations and Safety Codes. Upon arrival, LPA met with Licensee, Sharon Moch. LPA explained the purpose of the inspection, and there were 7 children in care LPA was guided on a tour of the on limits areas of the home inside and outside by Licensee.

The following was observed and discussed with the Licensee during the inspection
Home is a 2-story dwelling that includes the following:
· 4 bedrooms, (3 that are off limits), the rear bedroom has been re-designed into an area used as the primary care area of the facility. The primary care area has its own full bathroom for use by clients
· 3 bathrooms (2 off limits).
· 1 kitchen (off limits)
· 1 living-room (off limits), according to the licensee this is where primary care is provided.
· 1 front yard (off limits).
· 1 back yard (on limits), backyard also includes many shaded areas.
· 1 attached garage (off limits).
The following was also observed by LPA during the inspection
1. All adults living in the home have submitted fingerprints and child abuse index check forms to Department of Justice.
2. Home is neat and clean.
3. Heat and air conditioning are provided from ceiling vents that are inaccessible to children.

4. Home is equipped with a fully charged fire extinguisher which is at least a 2A:10BC.


5. Home is equipped with a working smoke alarm and a carbon monoxide detector.
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SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2022
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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Document Has Been Signed on 11/16/2022 11:16 AM - It Cannot Be Edited


Created By: Doris Whitmore On 11/16/2022 at 10:23 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MOCH FAMILY CHILD CARE
FACILITY NUMBER: 197417533

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.1(a)(6)
Personnel Records
(a) Personnel records shall be maintained on each employee and shall contain the following information: (6) Documentation of completion of training on preventative health practices as required by Section 102416(c).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [1] out of [1] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/30/2022
Plan of Correction
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Licensee will take the class and email the certifiocate to the LPA.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Karren Starks
LICENSING EVALUATOR NAME:Doris Whitmore
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2022


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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MOCH FAMILY CHILD CARE
FACILITY NUMBER: 197417533
VISIT DATE: 11/16/2022
NARRATIVE
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6. Home has a working telephone.
7. All poisons are locked.
8. Hazardous materials are kept out of the reach of children (inaccessible):
Kitchen: all sharp utensils and cutlery, cleaning supplies, medicines, drawers and cabinets with liquor, plastic bags, and sharp things or small things children can swallow.
Bathroom: shampoo, mouthwash, toothpaste, medicines, and perfumes/lotions/cosmetics.
9. According to the licensee, there are no weapons or firearms at the home. None were observed by LPA.
10. Outdoor play area is free from defects or dangerous conditions.
11. Outdoor play area is fenced in.
12. No bodies of water were observed during the inspection.
13. Toys and playthings are safe, clean, and appropriate for the age of the children.
14. Licensee agrees that no baby walkers, bouncers, jumpers, and similar items will be used for children in care and are kept inaccessible.
15. LPA observed Mandated Reporter Training Certificate date of competition 11-11-21 LPA also observed 1st Aid and CPR card(s) that expire on 10-26-23 LPA observed a total of 7 children files.
16. The home is equipped with a first aid kit.
The following was thoroughly discussed with the licensee
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

Licensee was reminded of their responsibility to report suspected child abuse. Mandatory Forms for the children’s files and provider’s files were discussed. Licensee was referred to LIC 311D: Records To Be Maintained At The Facility - Family Child Care Home. Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation.

Licensee was made aware that state law prohibits baby walkers, bouncy seats, 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. Page2

SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MOCH FAMILY CHILD CARE
FACILITY NUMBER: 197417533
VISIT DATE: 11/16/2022
NARRATIVE
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The licensee was advised the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days.

Licensee was made reminded that it is the licensee’s responsibility to know the regulations as well as anyone who assists in providing care. Licensee was advised on how to access quarterly reports, forms, and regulations for Child Care online at www.ccld.ca.gov. Licensee was also encouraged to read the Child Care quarterly updates every season as the come out to stay informed of any changes or updates to the regulations.


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. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.
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

The following was discussed with the Licensee
· Entrance Checklist & CARETOOL
· Forms Records to keep in your Family Child Care Home
· Preventative Health & Safety Flyer that includes Nutrition & Lead
· LA County Public Health Customer Support for Blue Cards (323) 869-8080

There were deficiencies cited during today's 11/16/2022 visit. An exit interview was conducted and a copy of the report was given to Sharon Moch. Page 3
SUPERVISORS NAME: Karren Starks
LICENSING EVALUATOR NAME: Doris Whitmore
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2022
LIC809 (FAS) - (06/04)
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