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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197419908
Report Date: 09/04/2019
Date Signed: 09/04/2019 01:54:50 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:HALL FAMILY CHILD CAREFACILITY NUMBER:
197419908
ADMINISTRATOR:HALL, CUPIDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 816-4752
CITY:LOS ANGELESSTATE: CAZIP CODE:
90018
CAPACITY:14CENSUS: 2DATE:
09/04/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Cupid Hall, LienseeTIME COMPLETED:
02:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Denise Gibbs conducted an unannounced annual random inspection to the above facility. Upon arrival LPA was met by Crystal Hamilton (licensee's sister) until licensee, Cupid Hall returned from dropping off children about 10 minutes later and guided analyst on a tour of the facility. Also present during this inspection, was Christian Beckley, Licensee’s Assistant and John McGraw (licensee's son). Per Licensee, there are 12 children that are currently enrolled. A current children’s roster was available for review. There were 2 children present upon arrival, 1 infant and licensee's niece.

This is a two-story home which consists of 3 bedrooms in upstairs and 3 bedrooms downstairs in the attached back house, 2 bathrooms, kitchen/dining room, living room, laundry room, front yard and backyard (fenced). Main care is provided in the living room and dining room areas. The children use the bathroom in the hallway adjacent to the main care area. LPA observed that there is a fireplace in the living room and is barricaded. Per Licensee, areas off limits to children and parents include: laundry room, 1 back bedroom and all areas downstairs (locked door). The licensee provides food for children in care. LPA observed food available in the refrigerator. Hours of operation are Mon-Sun 24 hours. Licensee was reminded that day-care children cannot be cared for a total of 24 hours.

The licensee states that 4 adults and 4 children currently live in the home. Per Licensee, she currently has four assistant. Licensee states that there are no firearms or weapons stored in the home.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cellphone that is used and the stays at the facility. during operation hours. There is ventilation and heating (ceiling fans, wall heater). The wall heater in the hallway is barricaded.
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019
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: HALL FAMILY CHILD CARE
FACILITY NUMBER: 197419908
VISIT DATE: 09/04/2019
NARRATIVE
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reviewed during this inspection. All homes shall conduct fire and disaster drills at least once every six months and document the date and time of each drill. Last drill documented was conducted on 2/2019.
Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. LPA did not observe anyone smoking in the home.

LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS, updated Parent’s Rights Poster with Complaint Hotline information, Capacity Handout (Small & Large) and Never Shake a Baby pamphlet. LPA also consulted and explained Child Abuse Reporting.

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

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.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov.


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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019
LIC809 (FAS) - (06/04)
Page: 3 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: HALL FAMILY CHILD CARE
FACILITY NUMBER: 197419908
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/04/2019
Section Cited

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Employees or volunteers at day care center; immunization requirements; records; exemptions
Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against
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influenza, pertussis, and measles. This requirement was not met by liencee failing to prodive proof of all immunizations for staff #1 and #2. This poses a potential threat to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 09/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/04/2019
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: HALL FAMILY CHILD CARE
FACILITY NUMBER: 197419908
VISIT DATE: 09/04/2019
NARRATIVE
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Senate Bill 792: this bill, commencing September 1, 2016, 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.

Requirements for fingerprint clearances and associations were discussed with the licensee. Licensee can be cited a civil penalty of $100 per day, up to $500.00 (5 days) for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period. The licensee was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation. The "Notification of Parent's Rights" (PUB394) poster must be posted in an area accessible to parents. The information regarding new legislation with regards to exemptions and Parent’s Rights was also discussed.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety



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.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the parent Acknowledgement of Receipt of Licensing Reports Form during this visit.

Exit interview was conducted with Cupid Hall, Licensee, including, but not limited to Appeal Procedures and Appeal Rights. -----------------------Page 4

SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019
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: HALL FAMILY CHILD CARE
FACILITY NUMBER: 197419908
VISIT DATE: 09/04/2019
NARRATIVE
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The following was observed and reviewed during this inspection:
Items which could pose a danger to children were observed to be accessible. LPA observed baking soda and peroxide in the the main care bathroom and air freshener in the living room and in the baby seat in the kitchen. Poisons are locked in the garage and in the laundry room.

The valve on the required 2A 10BC fire extinguisher indicates fully charged and was last serviced on 9/7/2018, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

The home inside is observed to be clean and orderly. There are toys and other age appropriate material available for children. Children nap on cots in the main care area. Infant pack n play (Graco) are visible in main care area and are free of hazards.

Currently, children are using the front and back yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did observe objects that can pose a danger to children on the outdoor yard. LPA observed a rusty broken adult table and chairs, an unraveled hose on the ground, motor oil in a box with children's toys, and rat poison in a small space with broken wood on the side of the house. LPA also observed the garage to be open with hazardous material inside and a car propped up on a jack in the driveway of the play area. There are no pools or spas, or other bodies of water. Licensee has a dog that is accessible to children during operating hours.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 7/2020 and assistant's expires 12/2019.

Children’s records were reviewed, including emergency information and were observed to be complete.

The licensee does not have proof of immunization. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.

LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files ------Page 2
SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2019
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: HALL FAMILY CHILD CARE
FACILITY NUMBER: 197419908
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/09/2019
Section Cited

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Operation of a Family Child Care Home
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

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Storage areas for poisons, firearms and other dangerous weapons shall be locked.


This requirement was not met as evidenced by LPAs observing LPA observed a rusty broken adult table and chairs, unraveled hose on the ground, motor oil in a box with children's toys, and rat poison in a small space with broken wood on the side of the house. LPA observed the garage to be open with hazards inside and a car propped up on a jack in the driveway of the play area and . LPA observed baking soda and peroxide in the the main care bathroom and air freshener in the living room and in the baby seat in the kitchen. This poses an immediate health and safety risk to 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: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Denise GibbsTELEPHONE: (323) 558-2794
LICENSING EVALUATOR SIGNATURE:
DATE: 09/04/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/04/2019
LIC809 (FAS) - (06/04)
Page: 5 of 6