197493379-10-19-2021-30-CC-SPOL-C7XPVR-20211019113935

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493379
Report Date: 10/19/2021
Date Signed: 10/19/2021 11:39:51 AM

Document Has Been Signed on 10/19/2021 11:39 AM - 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:	WOODS FAMILY CHILD CARE		FACILITY NUMBER:	197493379
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 10	CENSUS: 0	DATE:	10/19/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Carol Woods, Licensee		TIME COMPLETED:	12:11 PM

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On 10/19/2021 Licensing Program Analyst (LPA) Shandra Powell conducted an announced inspection with Carol Woods for the purpose of an increase of capacity inspection for 1227 W. 84th Street, Los Angeles, CA 90044. The purpose of this increase of capacity visit is to ensure the standards for a Family Child Care Home are being met in accordance to California Title 22 Regulations and California Health and Safety Codes.
The licensee is applying for an increase of capacity; Large Family Child Care Home license for a maximum capacity of 14. A fire clearance was approved by LA County Fire Department on 10/17/2021. Facility was licensed for a Small (8) Family Child Care Home on 03/08/2017.

The applicant rent/leases the property and landlord consent was received with a copy of the rent/lease agreement.

The capacity of the Large Family Child Care Home is 14. Per the application, at this time, the ages the applicant wishes to provide services for are children 6 weeks to 12 years old with the hours of operation of Monday- Sunday from 6:00 AM to Midnight. Applicant was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes.

This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen, dining room, living room, front yard and backyard (fenced) with detached garage. The living and dining room is furnished with toys and child size furniture. LPA observed cameras in living and dining room. Applicant also stated Bedroom #2 has a camera. The dining room has child size chairs and a table. The children use the bathroom located between 2 bedrooms that is accessible through the second bedroom for children in care. LPA observed that there is a wall heater in living room and bedroom number two which are both barricaded. Per Applicant the master bedroom is the only off limits area to children and parents. LPA observed a bolt lock on master bedroom. Applicant is aware that bedroom number one (master bedroom) must stay locked at all times during child care hours. Bedroom #2, which has been designated as an On LIMITS area was observed. Children walk through Bedroom #2 to get to restroom. Children also use bedroom number 2 for activities.

Karren Starks
Shandra Powell
	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: WOODS FAMILY CHILD CARE	FACILITY NUMBER: 197493379
	VISIT DATE: 10/19/2021

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Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible. The applicant states that all poisons, medication and hazardous items are in the locked locker on back porch. The licensee does understand that poison must be locked with a key or combination lock. LPA observed two small dogs during inspection one located in bedroom #2 in a kennel and second dog located in backyard in kennel. LPA observed shot records for dog located in home only. Per licensee, both dogs are placed in kennels when children are in care.

Exiting the living room/dinning room area, you are led to the kitchen. Kitchen is used as a walkway to access the back yard. The stove, refrigerator, sink and counter space area were observed and inspected. Licensee prepares meal for the children in the program. A fire extinguisher was observed in the dining room space. First aid kit and earthquake essentials were observed under kitchen sink. All cabinets were observed to have safety latch, making them inaccessible to the children in care.

The outdoor space was observed to have a variety of age appropriate activities with a large wooden swing set. LPA observed a detached garage with chain locks that is currently being used for storage. LPA observed a working carbon monoxide and smoke detector and all electrical outlets were covered. LPA reminded licensee to make sure all dog feces and old fruit from trees in backyard are picked up prior to children accessing backyard to ensure the safety of the children in care.

Applicant stated she provides visual supervision at all times when children are in the back yard. Applicant stated no weapons, firearms or bodies of water on the premises. Posting requirements were observed all postings were posted during inspection.

LPA observed the children’s file to be complete. LPA was shown the Disaster Drill log, the last drill was completed on 09/11/2021.

Applicant 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.

SUPERVISOR'S NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: WOODS FAMILY CHILD CARE	FACILITY NUMBER: 197493379
	VISIT DATE: 10/19/2021

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LPA discussed the safe sleep regulations with Applicant LPA observed Safe Sleep Log for infant during inspection:Https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant 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.

Applicant was made aware 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

Immunizations: Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

Mandated Reporter Training: Beginning on January 1, 2018, AB 1207, 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. Licensee was reminded of their responsibility to report suspected child abuse.

Capacity and Ratios: The licensee has applied for a capacity increase for a large family . The Maximum capacity is 12 with no more than 4 infants and a qualified assistant. Without a qualified assistant the license reverts back to the requirements for a small family childcare. Optional care may be provided for a maximum capacity of 14 children with no more then 3 infants, 2 school age children and a qualified assistant. School age children must be 1 age 6 yrs and 1 in Kindergarten.

SUPERVISOR'S NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

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: WOODS FAMILY CHILD CARE	FACILITY NUMBER: 197493379
	VISIT DATE: 10/19/2021

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FORMS TO BE POSTED
· LIC203 Facility License
· LIC 610A Emergency Disaster Plan
· LIC 9148 Earthquake Preparedness Checklist
· PUB394 Notification of Parents Rights Poster
Children’s records requirements:
· LIC 700 Identification and Emergency Information
· LIC 627 Consent for Emergency Medical Treatment
· LIC 282 Affidavit Regarding Liability Insurance
· LIC 9150 Parent Notification Additional Children in Care
· Immunization record
· PUB 72- Family Child Care Consumer Guide
· LIC 995A Notification of Parent’s Rights
· CDPH 286 (Immunization Blue Card)
FACILITY RECORDS:
· LIC 624B Unusual Incident/Injury Report
· LIC 9040 Child Care Facility Roster
· LIC 9052 Employee Rights,
· LIC 9108 Statement Acknowledging Requirement to Report Child Abuse
· LIC 9149 Landlord Consent Form, if you plan to care for more than 6 children for a Small
· LIC 9151 Property Owner/Landlord Notification Form
· Proof of current pediatric CPR and First Aid Certificates

CA Department of Public Health Guidance for Child Care Providers and Programs: LPA observed and discussed COVID-19 recommedations with applicant. https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/COVID-19/Child-Care-Guidance.aspx

At this time, the applicants home meets the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of the California Code of Regulations, and will be submitted for approval to be licensed as a Large Family Child Care Home.
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 applicant, and Appeal Procedures provided.

SUPERVISOR'S NAME: Karren Starks
LICENSING EVALUATOR NAME: Shandra Powell
LICENSING EVALUATOR SIGNATURE:	DATE: 10/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2021

LIC809 (FAS) - (06/04)

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