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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197417591
Report Date: 02/23/2022
Date Signed: 02/23/2022 11:52:56 AM


Document Has Been Signed on 02/23/2022 11:52 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:DOCKERY FAMILY CHILD CAREFACILITY NUMBER:
197417591
ADMINISTRATOR:DOCKERY JUANITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 296-0489
CITY:LOS ANGELESSTATE: CAZIP CODE:
90062
CAPACITY:12CENSUS: 4DATE:
02/23/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
10:56 AM
MET WITH:Juanita Dockery, LicenseeTIME COMPLETED:
11:42 AM
NARRATIVE
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Licensing Program Analyst (LPA) Alicia Mooberry conducted an unannounced inspection on 02/23/22. LPA arrived at the facility at 9:50am and met with Verna Patnett, Assistant, LPA toured the facility. LPA observed, 4 children, including an infant in the living room of the home.

At 9:54am while touring the backyard and activity room. LPA observed a Presto Heat Dish on a table inside the activity room of the facility. The heat dish is observed to be glowing red (photo taken), LPA placed hand 3 inches in front of the dish and felt heat radiating. No children were in the room. This poses a potential risk to the health and safety of children in care.
Staff removed the dish out of the childcare room and placed it in inaccessible area to children in care.
Licensee stated they will replace the Presto Heat Dish with a portable heater that is not hot to the touch.
Deficiencies are being cited in accordance with Title 22 regulations.

Licensee Juanita Dockery was not present and arrived at 10:05am.
The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted with Juanita Dockery, Licensee, including, but not limited to Provider Rights, Appeal Procedures and Agencies Consultative Role.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2022
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 02/23/2022 11:52 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754


FACILITY NAME: DOCKERY FAMILY CHILD CARE
FACILITY NUMBER: 197417591

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/23/2022
Section Cited

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The home shall be free from defects or conditions which might endanger a child... Fireplaces and open-face heaters shall be screened to prevent access by children...

This requirement is not met as evidenced by:
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LPA observed a Presto Heat Dish on a table inside the activity room of the facility. The heat dish is observed to be glowing red and hot to the touch (photo taken). No children were present in the room. This poses a potential risk to the health and safety of children in care.
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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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 02/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/23/2022
LIC809 (FAS) - (06/04)
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