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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197418812
Report Date: 02/16/2023
Date Signed: 02/16/2023 01:56:34 PM


Document Has Been Signed on 02/16/2023 01:56 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:DENNIS FAMILY CHILD CAREFACILITY NUMBER:
197418812
ADMINISTRATOR:DENNIS, CHANEAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 686-9130
CITY:LOS ANGELESSTATE: CAZIP CODE:
90044
CAPACITY:12CENSUS: 0DATE:
02/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Chanea Dennis, LicenseeTIME COMPLETED:
02:13 PM
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Licensing Program Analyst (LPA) Shandra Powell conducted an unannounced annual inspection on 02/16/2023. A Risk Assessment for COVID-19 was completed before entry. LPA met with Chanea Dennis, Licensee. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided to the licensee upon entry. The facility operating hours/days are Monday thru Friday from 8am to 6:00 pm. This is a one story home. Per Licensee 1 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 did not observed any children in home during inspection. Licensee stated she has school age children only at this time.

Licensee guided analyst on a tour of the facility. LPA observed Facility License and Notification of Parents Rights and Earthquake Preparedness documents posted in a pubicly area at the facility. LPA reviewed the Emergency Disaster Plan LIC610A, Disaster, Fire Drill Log (last drill 02/03/2023) and Facility Roster LIC 9040.

The home is a one story, four bedroom two bathroom home with a living room and kitchen. Licensee observed the backyard and the attached garage. Licensee stated the garage is only used for storage. Per Licensee, there is no child care conducted in the attached garage. The off-limit areas of the home are the four bedrooms and one bathroom. Children in care use the restroom off the hall between bedroom 3 and 4.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:
DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/10/2023
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: DENNIS FAMILY CHILD CARE
FACILITY NUMBER: 197418812
VISIT DATE: 02/16/2023
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The bedrooms are made inaccessible with child door locks.

The children will eat in the kitchen area and nap and play in the living room. The isolation area will be closer to the bar area for ill children per licensee. 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. There is two wall heaters located in the living room and in the hall way of the home LPA observed both are screened. There are safety latches on the cabinets in the kitchen. There is also a locked storage cabinet, for chemicals and hazardous materials, through the hallway next to the bathroom. The home uses a AC Unit for a cooling source located in living room attached to the wall above the television. Home has a working telephone per licensee the number on file is the cell number. Hazardous materials in the kitchen and bathroom are inaccessible to children. LPA observed cleaning compounds under sink in locked cabinet in kitchen during inspection. According to the Licensee, there are no weapons or firearms at the home; None were observed by LPA..
LPA observed a fire extinguisher which is at least a 2A:10BC located in the kitchen, however has not been serviced within a year. LPA reminded licensee that the fire extinguisher must be serviced yearly and or a new fire extinguisher must be bought. 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 observed a current First Aid/ CPR certificate for Licensee with a completion date of 02/12/2023. Licensee Mandated Reporter Certification has expired. This is a potential health and safety risk to children in care.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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: DENNIS FAMILY CHILD CARE
FACILITY NUMBER: 197418812
VISIT DATE: 02/16/2023
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Due to licensee caring for only school age children at this time LPA did not observed toys and playthings for children in the home. LPA observed a basketball court in the backyard of the home for children. . 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.

Per licensee the outside play for the children is conducted in the back yard of the home, per Licensee, supervision of the children is provided at all times by Licensee during outside play time. During inspection No pools, spas, hot tubs, fish ponds, or similar bodies of waters observed during the inspection..

LPA attempted to review children's file during today's inspection however the licensee did not have a file on hand for review. LPA instructed licensee to print out the below forms for signatures and completion of parents and obtain child's updated immunization's. The following must be in each child's file; LIC 700 (Identification and Emergency Information), LIC 627 (Consent for Emergency Medical Treatment), LIC 995A (Notification of Parents' Rights). and immunization records. This is a potential Health and Safety Risk to children in care.


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.
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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: DENNIS FAMILY CHILD CARE
FACILITY NUMBER: 197418812
VISIT DATE: 02/16/2023
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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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm.
regulations and quarterly updates online at: www.ccld.ca.gov. Licensee stated she is receciving the Provider Information Notices (PIN)

U.S. CONSUMER PRODUCT SAFETY COMMISSION FISHER-PRICE INFANT EQUIPMENT RECALLS: PIN 20-19 advise licensee to print PIN to review. 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
SUPERVISOR'S NAME: Karren StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
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: DENNIS FAMILY CHILD CARE
FACILITY NUMBER: 197418812
VISIT DATE: 02/16/2023
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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.

Deficiency Type B Citation and Technical Violations were issued during inspection to protect the children's health and safety.



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 StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
LIC809 (FAS) - (06/04)
Page: 5 of 13
Document Has Been Signed on 02/16/2023 01:56 PM - 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245


FACILITY NAME: DENNIS FAMILY CHILD CARE
FACILITY NUMBER: 197418812

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview the licensee did not comply with the section cited above in which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 02/21/2023
Plan of Correction
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The licensee will eamil the copy of certificate on or before Plan of Correction date.
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 StarksTELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra PowellTELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2023
LIC809 (FAS) - (06/04)
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