197493408-10-11-2022-30-CC-DWHE-CK4QTQ-20221011122731

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197493408
Report Date: 10/11/2022
Date Signed: 10/11/2022 12:27:50 PM

Document Has Been Signed on 10/11/2022 12:27 PM - 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:	GREENWOOD FAMILY CHILD CARE		FACILITY NUMBER:	197493408
ADMINISTRATOR:	GREENWOOD, JENEA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 301-8804
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	14	CENSUS: 3	DATE:	10/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:08 AM
MET WITH:	Jenea Greenwood		TIME COMPLETED:	12:30 PM

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Licensing Program Analyst (LPA) Doris Whitmore conducted an unannounced annual random inspection to ensure the health and safety of the Child Care Home according to Department Regulations & Safety Codes. All adults are present and residing in the home are fingerprint cleared and associated to the facility. At the time of the inspection was the licensee and four children in care. Days of Operation are Monday- Friday 5:00 a.m. to 8:00p.m. LPA was guided on a tour inside and outside of the home. Licensee provides for the children breakfast, lunch, one snacks, & water.

This is a two story apartment with 3 bedrooms, 2 bathrooms, living room, kitchen, dining room, and laundry room. Childcare areas are: living room, dining room, and bathroom 1. Off-limits areas are: bedroom 1, bedroom 2, bedroom 3, bathroom 2, kitchen, and laundry room.

Indoor

LPA entered the property through the main entrance that leads to the apartment complex. The unit is located at the rear on the right side. LPA entered the home through the entrance door that leads into the living room and dining room, which is the primary childcare area. In the living room, LPA observed 1 couch, shelving secured to the wall with age-appropriate toys and games, 1 children's table, and a reading nook with books. In the dining room, LPA observed cubbies, a toy kitchen, cots, children's chairs. Bathroom 1 can be accessed via the kitchen and through the laundry room. LPA observed 1 sink and 1 toilet. Licensee states she escorts children to the bathroom. LPA observed a functioning smoke/carbon monoxide detector in the living room. Licensee has a 3-A:40- B:C fire extinguishers in the living Cleaning supplies are stored in the upper cabinets of the laundry room.

Indoor Off-Limits

The second floor is made inaccessible by child safety gate. Bedroom 1-3, and bathroom 2 are located on the second floor. The kitchen is made inaccessible by a child safety gate. LPA observed child safety latches on all cabinet doors and child safety knobs on the stove.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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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Document Has Been Signed on 10/11/2022 12:27 PM - It Cannot Be Edited

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: GREENWOOD FAMILY CHILD CARE	FACILITY NUMBER: 197493408
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [1] out of [1 [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/18/2022
	Plan of Correction
1 2 3 4	Licensee stated that she will go on the website to take the Mandated Reporter Training and email the certificate

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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: GREENWOOD FAMILY CHILD CARE	FACILITY NUMBER: 197493408
	VISIT DATE: 10/11/2022

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Outdoor
Licensee stated that children play at the local park.

Licensee states there are no firearms or weapons of any kind in the facility at the time of the visit. Upon review of child files, LPA observed all required documents according to Title 22 Regulations. On the parent board, LPA observed the Emergency Disaster Plan and Notification of Family Child Care (PUB394). LPA also observed a First-Aid Kit fully stocked. All electrical outlets have protective covers.

LPA observed and checked a total of 10 children files . LPA observed some of the forms that were missing in the files . Some of the files had Notification of Parents'Rights Pub 394 and not LIC995 A. LPA shared with the Licensee the Entrance Checklist- Family Child Care Homes to use as a Guidance. LPA also shared with the Licensee Forms/ Records to Keep in your Family Child Care Home. Some Files had the Identification and Emergency Cards& Consent for Emergency Medical Treatment some files were missing the forms. LPA observed and reviewed Licensee file first and CPR date completed 6//6/21 expires in two years. Mandated Reporter Certificate expired 3/7/22.

Baby Walkers/etc Prohibited. Licensee was made aware that state law prohibits baby walkers, bouncy seats, exersaucersand any other items that fall into that category. Health & Safety Code 1596.846(b) and (c).
Smoking Prohibited. Licensee was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family child care home during the hours of operation. Health & Safety Code 1596.795(a).

Shaken Baby Syndrome Awareness & SIDS. Licensee was reminded never shake a baby to prevent Shaken Baby Syndrome. LPA discussed Safe Sleep Regulations with Licensee: one crib or play yard for each infant in care; cribs and play yards are kept free from all loose articles and objects while infants are sleeping; no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider physically checks on sleeping infants every fifteen minutes and documents any signs of distress, which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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: GREENWOOD FAMILY CHILD CARE	FACILITY NUMBER: 197493408
	VISIT DATE: 10/11/2022

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High Chair & Car Seat Awareness. Licensee was also reminded that only children eating may be in high chairs and that car seats are utilized only for transportation.
Update on Incidental Medical Services: 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
Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Emptying an Ileostomy Bag.

Licensee informed that all persons employed or volunteering at a child care facility or family day care must be immunized against the following: influenza, pertussis and measles. LPA discussed the influenza waiver during the inspection.

The licensee was advised that, once licensed, 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, (Type A violation), 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.

LPA discussed AB633 and informed licensee that, upon receipt of a Type A deficiency, the licensee shall post and provide copies of this licensing report to parent/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

The licensee was made aware that a licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment.

Mandated Reporter Required. Licensee was made aware of AB 1207, commencing January 1, 2018, requires all licensed providers, Licensee, 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 Health & Safety Code 1596.8662.

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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: GREENWOOD FAMILY CHILD CARE	FACILITY NUMBER: 197493408
	VISIT DATE: 10/11/2022

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The following was discussed with the licensee:
All adults living and working in the home must be fingerprinted and cleared prior to entering the facility. The licensee was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day. The licensee may find additional information and forms on the DSS website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.
· Entrance Checklist- Family Child Care Homes
· CARETOOL
· Prohibited items in Family Child Care homes
· Forms Records to keep in your Family Child Care Home (LIC311D)
· L.A. County Public Health Customer Support for Blue Cards (323) 869-8080

There were deficiencies cited during today's visit Please see the D- Page. An exit interview was conducted, and a copy of this report was given to licensee Jenea Greenwood..

SUPERVISOR'S NAME: Claudia Escobedo	TELEPHONE: (424) 301-3044
LICENSING EVALUATOR NAME: Doris Whitmore	TELEPHONE: 424-301-3029
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

LIC809 (FAS) - (06/04)

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