197494304-8-16-2019-30-CC-PFLS-BF4R2U-20190816123854

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494304
Report Date: 08/16/2019
Date Signed: 08/16/2019 12:39:12 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:	DUPRE FAMILY CHILD CARE		FACILITY NUMBER:	197494304
ADMINISTRATOR:	OLIVIA DUPRE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 890-4750
CITY:	LOS ANGELES,	STATE: CA	ZIP CODE:	90064
CAPACITY:	14	CENSUS: 0	DATE:	08/16/2019
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Olivia Dupre - Licensee		TIME COMPLETED:	01:00 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	On 08/16/2019 at 11:45 AM, Licensing Program Analyst (LPA) Peter Flores, conducted an announced pre-licensing inspection to the facility to ensure the health and safety standards as required governing California family child care homes. Present at the time of inspection Olivia Dupre (applicant). Olivia states that she is the only adult living in the home at this time. Olivia states hours of operation for day care are Monday through Thursday, 8:00 AM to 6:00 PM, Fridays will till 5:00 PM. Olivia was advised during hours of child care that the applicant shall be present in the home and shall ensure children in care are visually supervised at all times. At 1:00 PM, LPA toured the facility the inside and outside. The home has three bedrooms, two bathrooms, kitchen, living room, and dining room. The entire home will be accessible to children in care. The 2 bedroom on each side of bathroom are off-limits to children in care. Olivia has submitted a disaster plan and demonstrated control of property at the above address by presenting Rental Agreement. Olivia has completed preventive health and safety/Childhood Nutrition and Mandated Reporter training. There are age appropriate toys and equipment for the children. Per Olivia, there are no firearms and weapons on the premises. There are toys available for children. The valve on the required 2A10BC fire extinguisher indicates fully charged. Smoke and carbon monoxide detectors were observed and tested during this inspection. Olivia has proof of CPR and First Aid training as indicated on the certificate. Olivia has proof of Health and Safety training and Pediatric First Aid and CPR (expires 01/2021). First Aid kit was observed.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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: DUPRE FAMILY CHILD CARE	FACILITY NUMBER: 197494304
	VISIT DATE: 08/16/2019

NARRATIVE

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Licensee was reminded that the following are guidelines and recommendations for best practices only. When the regulation is approved providers will be notified through Provider Information Notice (PIN).

*Always place infants on their backs for sleeping
*Use a tight-fitting sheet on the crib or play yard mattress
*Do not hang any items from the crib or above the crib
*Keep all items out of the crib or play yard
*Pacifiers may be used as long as they do not have items attached to them
*Infants should not be swaddled or have any items covering them while sleeping
*The temperature of the room should be comfortable enough for an adult to wear a
t-shirt and not be too hot or too cold.

Facility is ready for licensure after the Department receives the approved STD850 for a large family child care home capacity of 14.

An exit interview was conducted with Olivia Dupre. A copy of this report and all other Licensing reports must be made available to the public for 3 years.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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: DUPRE FAMILY CHILD CARE	FACILITY NUMBER: 197494304
	VISIT DATE: 08/16/2019

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.

New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. All appeals must be sent to:

300 N. Continental Blvd., Suite 290-A

El Segundo, CA 90245

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.

Assembly Bill 1207: California Child Care Workers; Mandated Training Requirement. Beginning January 1, 2018, all licensed providers, applicants, directors and employees must complete Mandated Reported Training prior to March 30, 2018 and renew training every two years at: www.mandatedreporterca.com.

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.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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: DUPRE FAMILY CHILD CARE	FACILITY NUMBER: 197494304
	VISIT DATE: 08/16/2019

NARRATIVE

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FACILITY RECORDS:
LIC9149 Property Owner/Landlord Consent, PUB 394 Notification of Parents Rights, PUB 269 California Child Passenger Safety Law, LIC 9040 Facility Roster, LIC624A Death Report, LIC6101A Emergency Disaster Plan, LIC9148 Earthquake Preparedness Checklist, LIC 624 Unusual Incident/Injury Report. LIC311D Forms/Records to keep In Your Family Child Care Home, Family Child Care Self-Assessment Guide.
STAFF RECORDS:
LIC 508 Criminal Record Statement, LIC 501 Personnel Record, LIC 503 Health Screening/TB, LIC9052 Employee Rights, LIC9108 Statement Acknowledging Requirement to Report Child Abuse, LIC 9163 Request for LIVESCAN, LIC9188 Criminal Record Exemption Transfer Request, LIC 9182 Criminal Background Clearance Transfer Request, LIC9052 Employee Rights.

The provider 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

The following were also discussed with the licensee:

Assembly Bill 633: Upon receipt by the licensee, licensees are to provide to parents/guardians the following: Copies of any licensing reports that document a Type A citation- this includes facility visits and substantiated complaint investigations; copy of licensing documents pertaining to a conference conducted by a local licensing agency management representative and the licensee of this family child care home in which issues of noncompliance are discussed or copies of a summary of an accusation indicating the Department's intent to revoke the facility's license. Copies of any of the above licensing documents the licensee has received in the prior 12 months shall be provided to parents/guardians of newly enrolled child at the facility.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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: DUPRE FAMILY CHILD CARE	FACILITY NUMBER: 197494304
	VISIT DATE: 08/16/2019

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The following was discussed with the applicant:

Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Failure to obtain a criminal record background check clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty.

-In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance associated to the facility license.

-A current roster of children enrolled must be available and maintained for a period of three years, even after children no longer are attending the facility.

-Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License shall be terminated.
-The fire extinguisher type 2A10BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should check and batteries replaced as needed.

-Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
-Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report)
-Fire and safety drills must be performed every six months and documented for review by the Department.
-Smoking is prohibited in a family child care home.
Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
-Dog(s) and or pets are recommended to be isolated from children in care.
- No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not permitted in the facility.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

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: DUPRE FAMILY CHILD CARE	FACILITY NUMBER: 197494304
	VISIT DATE: 08/16/2019

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-All adults living and working in the home shall be made of aware of the Departments right to inspection authority, which includes but not limited to the right to enter the home when children are being cared for, interview children and adults and review documentation.
- Licensees shall reveal each facility license number in all advertisements, publications or announcements with the intent to attract clients.
- Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are required to be posted.

The facility is not currently providing IMS. Incidental Medical Services (IMS) policy was discussed with the applicant. 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.html.

LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices which always Baby is sleeping on his/her back. Capacity Handout (Small & Large) was provided during this inspection.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

In addition, LPA distributed LIC-311D and explained the following forms:

LIC311D:
CHILDREN RECORDS: LIC: 700 Identification and Emergency Information, 702 Child’s Pre-admission Health History LIC 995E Caregiver Background Check Process, 995A Notification of Parent’s Rights, 627 Consent For Emergency Medical Treatment, 613A Personal Rights, LIC282 Affidavit Regarding Liability Insurance, LIC9150 Parent Notification, Additional Children in Care.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Peter Flores	TELEPHONE: (424) 301-3063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2019

LIC809 (FAS) - (06/04)

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