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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419780
Report Date: 05/22/2019
Date Signed: 05/22/2019 03:25:37 PM

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:BENN FAMILY CHILD CAREFACILITY NUMBER:
197419780
ADMINISTRATOR:BENN, LA WANDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 264-9419
CITY:COMPTONSTATE: CAZIP CODE:
90221
CAPACITY:14CENSUS: 4DATE:
05/22/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:La Wanda BennTIME COMPLETED:
03:40 PM
NARRATIVE
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Licensing Program Analysts Ariel Cazares and Reiko Jones conducted an unannounced annual random site inspection to ensure the health & safety standards as required by regulations governing family child care homes. Upon arrival, LPA met with Licensee La Wanda Benn and toured the facility. There were 4 children present. Individuals residing in the home are the licensee, spouse, and 2 biological and 2 foster children. Licensee’s operating hours are Monday-Friday, 8am-7pm.

The home is a two story, 7-Bed, 3-Bath home. The following areas are used for day-care: Daycare area near kitchen that consists of napping room, 1 restroom, and play room; along with the outdoor space on the side of the home (currently off limits due to clean up needed as a result of weather conditions). Off limit areas include: Kitchen, the living room, dining room, second floor, and backyard.

Licensee has the Parent’s Rights poster and other appropriate forms posted on wall in the living room. First Aid/CPR certificate are valid thru 06/2019. Licensee's did not have a disaster drill log available for review. Licensee has a working telephone.

LPA inspected areas used by the daycare. LPA observed that the sink cabinet in the children's restroom was not latched and there were cleaning compounds accessible, but were removed immediately. LPA captured a photo. LPA observed in the closet of the napping room a baby bouncer and reminded licensee that item is prohibited. Fire extinguisher in the facility did not have proof of service date and the gauge read in the "RED" needing to be recharged. There is an operational smoke detector and carbon monoxide in the daycare space. There are no firearms present on the premises as stated by licensee. Due to weather and a family gathering the outdoor space is not being used as it needs to be cleaned up. Licensee stated she is not having children go outside until it is ready for them. Licensee will submit photos to LPA prior to use of outdoor space. There are no pools or spas, or other bodies of water. Currently there's 1 dog in home.

SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 6
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: BENN FAMILY CHILD CARE
FACILITY NUMBER: 197419780
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2019
Section Cited
HSC
1597.622(c)
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The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person’s personnel record that is maintained by the family day care home.

This requirement has not been met as
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Per licensee, she will obtain copies of the immunization records for herself and her staff and submit to LPA by POC due date of 6/21/19.
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evidenced by facility not having immunization records for review of Staff #1, 2, 3.

This poses a potential risk to the health and safety of children in care.
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Type B
06/05/2019
Section Cited
CCR
102417(g)(8)
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Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.
This requirement has not been met as evidenced by facility not having a roster available for review. This poses a potential risk to the health and safety of children in care.
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Per licensee, she was not aware of the requirement for a roster. LPA provided a copy to licensee to complete and send to LPA by POC due date of 5/29/19.
Type B
06/05/2019
Section Cited
CCR
102418(g)
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The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement has not been met as evidenced by Child #1 & #2 missing record. This poses a potential risk to the health and safety of children in care.
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Per licensee, she will obtain copies from parents and submit copies to LPA by POC due date of 6/5/19.
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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: BENN FAMILY CHILD CARE
FACILITY NUMBER: 197419780
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/29/2019
Section Cited
CCR
102417(g)(4)
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Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.

This requirement has not been met as evidenced by LPAs observation of
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Licensee removed items from the cabinet.
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cleaning compounds in a cabinet in the children's restroom. This poses a potential risk to the health and safety of children in care.
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Type B
05/29/2019
Section Cited
CCR
102417(g)(9)(A)(1)
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The licensee shall document the drills, including the date and time of each drill. This documentation shall be kept at the family child care home.
This requirement has not been met as evidenced by facility not having documentation of disaster drills. This poses a potential risk to the health and safety of children in care.
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Per licensee, she will conduct a drill, document it, and submit proof to LPA by POC due date fo 5/29/19.
Type B
05/23/2019
Section Cited
CCR
102417(g)(10
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A baby walker shall not be allowed on the premises of a family child care home in accordance with Health and Safety Code Section 1596.846(b) and (c).
This requirement has not been met as evidenced by LPAs observation of a bouncer in the closet of napping room. This poses a potential risk to the health & safety of children.
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Per licensee, she will remove item immediately and submit a statement stated that she did so and will no longer use such items, by POC due date of 5/29/19.
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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 6 of 6
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: BENN FAMILY CHILD CARE
FACILITY NUMBER: 197419780
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/22/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/23/2019
Section Cited
CCR
10102417(g)(1)
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The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal.

This requirement has not been met as evidenced by LPAs observations that the 2 fire extinguishers in the facility did not have proof of service or purchase date and the
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Per licensee, she will purchase a new fire extinguisher and send proof of purchase to LPA by POC due date of 5/23/19.
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gauges on both read as needing to be charged.

This poses an immediate 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: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: BENN FAMILY CHILD CARE
FACILITY NUMBER: 197419780
VISIT DATE: 05/22/2019
NARRATIVE
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Children's roster and staff immunization records were not available for review. Children's files were reviewed. Two children were found to be missing copies of immunizations records.

The following were discussed: Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately. No smoking, No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category. LPA discussed disaster drills, posting requirements, children records requirements, mandated child abuse and injury/death reporting.
· LPA reviewed LIC 311D with licensee, reminding her of required forms. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Copy of Safe Sleep Concepts were provided.
· 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
· A qualified Assistant must be present and actively involved in caring for children whenever nine (9) or more children are present at the facility in a large family child care home.

Deficiencies were cited in accordance with California Code of Regulations Title 22. See 809-D. LPA advised the Licensee to access forms and regulations on line at: www.ccld.ca.gov

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: BENN FAMILY CHILD CARE
FACILITY NUMBER: 197419780
VISIT DATE: 05/22/2019
NARRATIVE
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Whenever a type A is cited: “Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.” LPA provided licensee with a copy of the lIC 9224 Acknowledgment of Receipt of Licensing Reports. A copy of the LIC 9224 must be placed in each child's file.

Exit interview was conducted with Licensee La Wanda Benn. A copy of this report and appeal rights were provided and explained.
SUPERVISOR'S NAME: Claudia GuangorenaTELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Ariel AlmazanTELEPHONE: (323) 981-2949
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019
LIC809 (FAS) - (06/04)
Page: 3 of 6