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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197493155
Report Date: 07/03/2019
Date Signed: 07/03/2019 11:07:17 AM

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:REAL FAMILY CHILD CAREFACILITY NUMBER:
197493155
ADMINISTRATOR:REAL, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 514-3001
CITY:SAN PEDROSTATE: CAZIP CODE:
90731
CAPACITY:14CENSUS: 12DATE:
07/03/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Ana Real, LicenseeTIME COMPLETED:
11:30 AM
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On June at 8:15 AM, Licensing Program Analyst (LPA) Miriam Cohen conducted an unannounced inspection and met with Ana Real, Licensee, of Real FCCH, 197493155 located at 444 W. 9th Street, San Pedro, CA 90731 for the purpose of an Annual Random Inspection.
Upon arrival, LPA observed 12 children being supervised by licensee and two adult assistants. All adults were fingerprinted and associated to the facility. LPA Cohen toured and inspected all rooms identified in facility sketch.

This is a one story, one-bedroom, two-bathrooms home with kitchen/dining, living room, and no garage. There is no pool, spa or other bodies of water on the premises. Family members residing in the home include licensee and spouse. The main care area is in the living and dining rooms with sleeping accommodation in the bedroom. The Licensee has installed a child safety gate so that children do not access the kitchen.
LPA Cohen observed age appropriate toys, learning materials, games and activities for children in care. All furniture was found in good repair, clean, and without hazards. Children utilize the bathroom located inside of main care area. The Bathroom is with locks and free from hazards. The kitchen is inaccessible to children in care. The facility is inspected inside and outside for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents/cleaning compounds (under sink with latch), and hazardous items (sharp knives in kitchen only) that can pose a danger to children.
Inspection of the outdoor play area is conducted. Age appropriate play equipment is found to be securely anchored with adequate resilient cushioning material underneath and around the perimeter. There is adequate shade for the children in care. Fencing around the perimeter of the back yard is at least 4 feet high. Backyard is free from miscellaneous debris such as tree branches, trash, leaves, etc.
Per licensee, there are no weapons or firearms of any kind in the facility at this time. LPA Cohen did not observe any weapons. Children nap in playpens and cots in the main care area.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
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 4
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: REAL FAMILY CHILD CARE
FACILITY NUMBER: 197493155
VISIT DATE: 07/03/2019
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The required fire extinguisher (2A10BC) and smoke detectors are in operable condition. A Carbon Monoxide detector is in place. Home has central A/C and heat. CPR/First Aid expires 03/2021. The First Aid kit was observed and is complete. Licensee has posted as required the License, Emergency Disaster plan, and Parents Rights Poster.

The following was discussed with the licensee: Mandatory Forms for the children’s files and provider’s files, Requirements for fire drills, earthquake drills, and documentation for both. The role and responsibilities of being a mandated reporter were discussed. The licensee was advised how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov Licensee was made aware that it is their responsibility to know the regulations as well as anyone who assists in providing care. The licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times. If the phone number has changed, licensing must be notified. Regulation prohibits the smoking of tobacco on the premises.
State law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. All infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome). The provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Only children eating may be in high chairs and that car seats are utilized only for transportation.
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.
The licensee was informed of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on child care licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: REAL FAMILY CHILD CARE
FACILITY NUMBER: 197493155
VISIT DATE: 07/03/2019
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AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com
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.
New Immunization Requirement: Law enacted by SB 277, beginning January 1, 2016, personal beliefs exemptions will no longer be an option for the vaccines that are currently required for entry into child care or school in California. Personal beliefs exemptions already on file will remain valid until the child reaches the next immunization checkpoint.
New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. Appeals may be mailed to the following address:
El Segundo Child Care Program Regional Office
300 N Continental Blvd., Suite 290A MS, 29-13
El Segundo, CA 90245
Nutrition Requirement: Beginning January 1, 2016, AB 290 will require for each new license issued, at least one director or teacher at each child care center or family child care home to have at least one hour of training in the importance of childhood nutrition. This applies to anyone submitting a new application, relocating their facility, selling their facility or transferring their license. Please note this training cannot be completed online or by home study programs. The training must be taken from an Emergency Medical Services Authority (EMSA) approved training program OR an accredited college or university.
The licensee was advised that the Notice of Site Visit must be posted at the entrance of the facility for a period of 30 days. If a serious violation is cited, a copy of the licensing report (LIC809 or LIC9099) must also be posted for 30 days. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed. Copies of the reports must also be provided to each parent when a serious deficiency, Type A, is cited (LIC9224).
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: REAL FAMILY CHILD CARE
FACILITY NUMBER: 197493155
VISIT DATE: 07/03/2019
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Update on 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 Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

An exit interview was discussed and conducted with the licensee.

The facility is operating in substantial compliance with the Title 22 Regulations at the time of inspection.

A copy of this report was read, signed, and provided to the licensee, Ana Real, on this date.

As of today, 07/03/19, there are NO Type A and B deficiencies/citations issued for the above facility.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3054
LICENSING EVALUATOR NAME: Miriam CohenTELEPHONE: (424) 301-3058
LICENSING EVALUATOR SIGNATURE:

DATE: 07/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019
LIC809 (FAS) - (06/04)
Page: 4 of 4