197420003-10-15-2019-30-CC-SPOL-BGZ2JP-20191015172641

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197420003
Report Date: 10/15/2019
Date Signed: 10/15/2019 05:26:54 PM

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:	KEY FAMILY CHILD CARE		FACILITY NUMBER:	197420003
ADMINISTRATOR:	KEY, CHARLETTE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 643-6787
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	14	CENSUS: 9	DATE:	10/15/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Charlette Key, Licensee		TIME COMPLETED:	05:50 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 random inspection to the above facility. Upon arrival, Licensee was not present. Licensee's assistant and husband were present with children (1 infant, 1 toddler and 7 preschoolers including school age children). Licensee arrived approximately 30 minuets into inspection. Upon LPA arrival, LPA observed infant in car seat awoke in the back room area of the home. LPA advised licensee and employees best practices are that infants do not use car seats for anything except transportation purposes. Employee gave LPA a tour of the home. Per Licensee, there are 9 children enrolled, LPA did not observed completed roster. This is a single dwelling home consists of 3 bedrooms, 2 bathrooms, kitchen, family room and living room and a detachable garage. Child care conducted in backroom and one bedroom and one rest room located in the back bedroom. The rest of the areas in the home are off-limits to children. LPA advised licensee to make hall way leading into off limit areas inaccessible. The home is observed to be clean and orderly. There are toys available for children. Appropriate sleeping arrangements were observed. LPA observed school age children completing home work at a table near backroom. The licensee provides food for children in care. Children also bring their own food and snacks. LPA advised licensee to label all food items brought into care. ---------------Page 1 of 4

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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

FACILITY NAME: KEY FAMILY CHILD CARE	FACILITY NUMBER: 197420003
	VISIT DATE: 10/15/2019

NARRATIVE

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The licensee and her husband are the only adults who live in the home. No children live in the home. Per Licensee, she currently has one assistant. All adults residing in the home have obtained a criminal record clearance or exemption. Licensee states that there are no firearms 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 (land line) at the facility. There is ventilation (air conditioner) and heating (furnace). The following was observed and reviewed during this inspection.

LPA observed detergent cleaning compounds inaccessible to children. Licensee stores items above washer and drawer in cabinet. Per Licensee, there are no poisons stored at the facility. The restroom that children use was observed to be safe and sanitary.

The valve on the required 2A 10BC fire extinguisher did not indicate fully charged however last service was in 2018. This poses a potential health and safety risk to children in care. Smoke and carbon monoxide detectors were tested and are operable.

Per licensee, children play in the backyard only. LPA observed it to be fenced in, safe and clean with appropriate outdoor materials. LPA did not observed any bodies of water at the home LPA observed a walkway in-between garage and fence that is big enough for children to walk through LPA observed front iron gate open. LPA advised licensee to make walkway inaccessible to children in care and to always keep front iron gate closed during business hours.

The licensee does have proof of Pediatric First Aid and CPR . Licensee CPR card expires 07/19/21. LPA advised licensee that all assistants will need to always have a valid Pediatric First Aid and CPR card due to licensee completing pick up and drop off of children during child care hours. There are first aid supplies available.
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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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

FACILITY NAME: KEY FAMILY CHILD CARE	FACILITY NUMBER: 197420003
	VISIT DATE: 10/15/2019

NARRATIVE

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Licensee and employees do not have proof of immunization's during inspection. This poses a potential health and safety risk to children in care.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. LPA did not observe log of drills conducted during inspection.

Emergency Disaster Plan, Poster and the Facility License were observed to be on a clipboard/wall. LPA advised the Licensee that the required forms to be posted need to be visible at all times.

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. Per Licensee, no one smokes 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 the New Proposed Safe Sleep Regulations and Best Practices, Helping you to reduce the risk of SIDS. LPA also consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information.

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SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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

FACILITY NAME: KEY FAMILY CHILD CARE	FACILITY NUMBER: 197420003
	VISIT DATE: 10/15/2019

NARRATIVE

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Incidental Medical Services (IMS):
The licensee states that the facility does not 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 available at: http://www.ada.gov/childqanda.htm.

INFORMATION TO BE POSTED IN YOU FAMILY CHILD CARE HOME – You are required by Law to post the following:
Facility License (LIC 203), Emergency Disaster Plan (LIC 610A), Earthquake Preparedness Checklist (LIC 9148), Notification of Parent’s Rights (PUB 394). A Notice of Site Visit (LIC 9213): Must be posted for 30 days after each site inspection by a Licensing Representative. Any Licensing Report documenting a Type “A” deficiency must be posted for 30 days during the hours that children are in care. Any Licensing Report or other document verifying compliance or non-compliance with the Department’s order to correct a Type “A” deficiency must be posted for 30 days during the hours that children are in care.

LPA advised the licensee to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. LPA obtained licensees email to add to ccld.ca.gov website to receive important up dates via email.

Based on the LPA observations and records review, the following deficiencies listed on the attached LIC 809D 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.

Exit interview was conducted with Charlette Key, Licensee, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights. --------------Page 4 of 4

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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

FACILITY NAME: KEY FAMILY CHILD CARE	FACILITY NUMBER: 197420003
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/15/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/21/2019 Section Cited	1 2 3 4 5 6 7	Each child day care facility shall maintain a current roster of children who are provided care in the facility. The roster shall include the name, address, and daytime telephone number of the child's parent or guardian, and the name and telephone number of the child's physician.
	8 9 10 11 12 13 14	This roster shall be available to the licensing agency upon request. The requirement was not met by LPA did not observe a completed updated roster during inspection.	8 9 10 11 12 13 14
Type B 11/01/2019 Section Cited	1 2 3 4 5 6 7	Employees or volunteers at day care center; immunization requirements; records; exemptions The day care center shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel
	8 9 10 11 12 13 14	record that is maintained by the day care center. This requirement is not met as evidenced by LPA observing that the Licensee and Employees does not have proof of immunization against measles, pertussis, and influenza and TB. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14

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: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

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

FACILITY NAME: KEY FAMILY CHILD CARE	FACILITY NUMBER: 197420003
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/15/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/21/2019 Section Cited	1 2 3 4 5 6 7	Operation of a Family Child Care Home 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 is not met as evidenced by
	8 9 10 11 12 13 14	LPA observing that the Licensee does not have any documentation to conducting drills. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

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: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Shandra Powell	TELEPHONE: (323) 981-3383
LICENSING EVALUATOR SIGNATURE:	DATE: 10/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2019

LIC809 (FAS) - (06/04)

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