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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494338
Report Date: 01/16/2020
Date Signed: 01/16/2020 02:36:46 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:ANDREWS FAMILY CHILD CAREFACILITY NUMBER:
197494338
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
01/16/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Felicia AndrewsTIME COMPLETED:
02:55 PM
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On 1/16/2020 at 1:00 PM Licensing Program Analyst (LPA) Angeilca Ramirez conducted a case management inspection at the Andrews Family Child Care home for the purpose of an increase in capacity. The licensee is applying for a large family child care home and is currently licensed for a small license for a capacity of eight. Upon arrival, LPA met with the licensee Felicia Andrews. Residing in the home is licensee and licensee's biological child (age eight) and granddaughter (age two). The fire clearance was granted for 14 children on 9/17/2019 by Inspector Leon Jones from Los Angeles City Fire Department.

Upon arrival LPA observed four children present as well as licensee's volunteer, who is cleared per LIS. The facility is a two bedroom, one bathroom home that consists of living room, kitchen/dining room, front yard and back yard and detached garage. Main care is provided in the living room and kitchen/dining area for school age children. The off-limits areas are: two bedrooms, backyard, and garage. Licensee states there are no weapons/firearms in the home, and none observed by LPA. There are no bodies of water on the property.

At this time, the licensee does not provide Incidental Medical Services (IMS).
The following was discussed with the licensee:
The licensee was informed to have a qualified assistant when the capacity exceeds eight children. The assistant must be at least 14 years of age, but can not be left alone with the children in care. If the assistant is 18 years of age and older, the assistant must have current Adult/Infant & Pediatric First Aid certificates if left alone with children while the licensee is out of the home. Each assistant must also have TB clearance, valid criminal record clearance and be associated to the facility license.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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: ANDREWS FAMILY CHILD CARE
FACILITY NUMBER: 197494338
VISIT DATE: 01/16/2020
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The licensee was informed of the responsibility to report suspected Child Abuse by calling the Child Abuse Hot line at 1-800-540-4000. Also call the CCL office and follow up with a written Unusual Incident/Injury Report (LIC 624B).

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) 524-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

The following was discussed with the licensee:

Licensee and licensee's were informed, Absence of Supervision: including, but not limited to, a child left unattended, a child left alone with a person under 18 years of age, and lack of supervision resulting in a child wandering away. (HSC 1597.58(c)(2)). Regulation(s): 102417(k)(1) Children shall not be left in parked vehicles. Civil penalty applies when a child is left unattended in a parked vehicle.
-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.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
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: ANDREWS FAMILY CHILD CARE
FACILITY NUMBER: 197494338
VISIT DATE: 01/16/2020
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- 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.

During this inspection, LPA also provided licensee with a safe sleep flyer and discussed and explained safe sleep practices. Infants must be placed on their backs, they must be monitored every 15 minutes and their temperature, color of skin and breathing must be monitored. No blankets bottles or toys in the crib. LPA advised licensee to never shake a baby.

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

LPA also discussed a letter received from the Caregiver Background Check Bureau dated 1/6/2020 regarding Individual #1 Peter Andrews with the licensee. Licensee confirmed Individual #1 does not reside here, LPA did not see individual present in the home. See LIC812 for additional details.

There are no corrections needed at this time. The licensee is approved for a large family day care license with a capacity of 14.



An exit interview was conducted and a copy of this report was provided to Ms. Andrews along with a notice of site visit.
SUPERVISOR'S NAME: Sharalyn Jenkins-SweetenTELEPHONE: (424) 301-3077
LICENSING EVALUATOR NAME: Angelica RamirezTELEPHONE: (424) 301-3071
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2020
LIC809 (FAS) - (06/04)
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