197419481-7-29-2022-30-CC-SPOL-CGSUZD-20220729160121

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197419481
Report Date: 07/29/2022
Date Signed: 07/29/2022 04:01:41 PM

Document Has Been Signed on 07/29/2022 04:01 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:	POE FAMILY CHILD CARE		FACILITY NUMBER:	197419481
ADMINISTRATOR:	POE, DEANN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 531-2256
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	14	CENSUS: 8	DATE:	07/29/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Deann Poe		TIME COMPLETED:	03:57 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 Required Inspection on 07/29/2022. LPA met with Deann Poe, Licensee. During today's inspection, LPA observed 8 children in attendance. LPA toured the inside and outside of the home. The home is two stories with four bedrooms, two and a half bathrooms, kitchen, family room, drop down room adjacent to family room, laundry room and detached garage with a room attached. Per Licensee, no childcare is conducted in the attached garage. Licensee confirmed that the family room located through the hallway to the rear of the home is the primary childcare area. LPA observed age appropriate toys in the childcare area. All bedrooms in the home and the bathroom located upstairs are off-limits and made inaccessible to children in care by use of closed and/or locked doors during operation hours. LPA observed a child gate at the bottom stairwell entrance to the second floor of the home located in the family room. LPA observed a glass sliding door in family room. LPA did not observe pool, spa, hot tub or other similar bodies of water on the premise. Per Licensee, there are no firearms, ammunition or weapons on the premise; none were observed by LPA. Page 1

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

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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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: POE FAMILY CHILD CARE	FACILITY NUMBER: 197419481
	VISIT DATE: 07/29/2022

NARRATIVE

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All poisons are locked. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible.

The home is equipped with a fully charged fire extinguisher which is at least a 2A:10:BC LPA observed a new fire extinguisher with purchased date of 07/29/2022. LPA informed licensee to service the fire extinguisher every year and or buy a new one. The home is equipped with a functional carbon/smoke detector which was tested during inspection. There is a first aid kit equipped in the home. Centralized heat and air conditioning along with fans are utilized as heating and cooling sources.

The home has working telephone service and LPA confirmed the phone number is on file. The home contains a (Ring) Doorbell on front porch.

The outdoor play is conducted in the front and back yard. LPA advised Licensee, if children are transported to and from to have parent/authorized representative sign an agreement of consent and place in child's physical file. LPA also advised Licensee that a copy of the transporter's driver's license and insurance is to be placed on file at the facility. The vehicle must have insurance at all times. Licensee ensures that children in care, are supervised at all times and is aware children shall not be left in parked vehicles.

Licensee completed Mandated Reporter training on 04/09/2021. LPA advised Licensee that Mandated Reporter training is to be renewed every two years and certificate of completion is to be placed in each employee's physical file.

LPA observe Emergency Disaster Plan posted on the parent board ar the entrance of facility.

Per Licensee, Licensee's CPR/First Aid certification expires in March 2023.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: POE FAMILY CHILD CARE	FACILITY NUMBER: 197419481
	VISIT DATE: 07/29/2022

NARRATIVE

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LPA observed required postings posted (PUB 394 Notification of Parents Rights, LIC 9148 Earthquake Preparedness and Facility License). LPA observed documents to be reviewed during inspection (LIC 610 A Emergency Disaster Plan, Disaster and Earthquake and Fire Drill was conducted 06/22. LIC 9040 Facility Roster. Roster completed with children enrolled. LPA reminded Licensee emergency disaster drills are to be conducted at least once every month.

Furniture and equipment were inspected for cleanliness, age appropriateness & good repair. Napping & Bedding equipment were inspected for cleanliness & good repair.

The Backyard is fully fenced. Licensee states children play in front and backyard LPA inspected the backyard for safety, potential hazards. Toys and play equipment are age appropriate and in good repair.

A review of the children's records was conducted and are found to have the following: LIC 282 Affidavit Liability Insurance, LIC 627/Consent for Medical Treatment, LIC 700 and Emergency Information, LIC 995A/Parent's Rights, PM 286/Immunization (Blue) Card.

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 if Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: CommonlyAsked Questions about Child Care Centers and the ADA available at: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: POE FAMILY CHILD CARE	FACILITY NUMBER: 197419481
	VISIT DATE: 07/29/2022

NARRATIVE

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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.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

The licensee appears to be within substantial compliance with Title 22 Regulatory Requirements.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

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

Licensee is reminded that smoking is prohibited on the premises during hours of operation

An Exit interview was conducted. The copy of this report was provided to licensee with appeal rights.

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (424) -30-3038
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (424) 301-3053
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2022

LIC809 (FAS) - (06/04)

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