197494401-6-4-2021-30-CC-LJCS-C3NNK4-20210604103119

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494401
Report Date: 06/04/2021
Date Signed: 06/04/2021 10:31:42 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:	FULLER FAMILY CHILD CARE		FACILITY NUMBER:	197494401
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	06/04/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Claudette Fuller		TIME COMPLETED:	10:25 AM

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 6/4/2021 at 9:00AM, Licensing Program Analyst (LPA) Lillian Casillas conducted an announced Increase In Capacity Pre-Licensing Tele-Inspection via FaceTime with Licensee, Claudette Fuller. Licensee guided LPA Casillas on a tour of the inside and outside of the Family Child Care Home. Hours of operation are Monday through Sunday, 24 hours. LPA observed 4 children in care and 1 adult present. This facility is a single story, 3 bedroom, 2 bathroom home with a family room, living room, kitchen, front yard, backyard, and garage. Childcare areas are: family room, bathroom #1, and backyard. Off-limits areas: bedroom #1, bedroom #2, bedroom #3, bathroom #2, kitchen, living room, front yard, and garage. Indoor Parents drop off and pick up their children via the side gate on the left side of the home, which leads to the backyard. Parents ring a door bell to notify Licensee of their arrival. LPA observed a poster on the gate related to COVID-19 symptoms and etiquette. Children enter the home via the backdoor into the family room, which the primary child care area. LPA observed toys, individual cubbies, books, 2 table and chair sets, 3 cribs, 3 play pens, 1 changing table, 1 dining table, and a TV. Bathroom #1 can be accessed via the family room and includes 1 toilet, 1 sink, and 1 bathtub. Licensee demonstrated the cabinet underneath the sink is made inaccessible with a child safety latch. Off-Limits Indoors LPA observed a baby gate separating the family room from the kitchen and hallway. In the kitchen, LPA observed child safety latches on the lower cabinet doors and pantry doors. LPA observed a clean and organized refrigerator. Licensee provides breakfast, lunch, dinner, and snacks. In the living room, LPA [CONTINUE ON PAGE 2]

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

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: FULLER FAMILY CHILD CARE	FACILITY NUMBER: 197494401
	VISIT DATE: 06/04/2021

NARRATIVE

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observed a screen secured and bolted to ensure the fireplace is inaccessible to children. The hallway leads to bedroom #2 and bedroom #3. Bedroom #2 is Licensee's daughter's bedroom and bedroom #3 is Licensee's son's bedroom. The hallway also includes a linen closet where Licensee stores cots and mats. The door to the linen closet is locked. Bedroom #1 is located near the living room. Bathroom #2 can be accessed via bedroom #1.

Outdoor
The outdoor play area is located in the backyard, which is fully fenced and features a covered patio and grassy area. LPA observed 2 children's houses, toy cars, and 1 slide. LPA observed a table with a touchless thermometer, masks, gloves, hand sanitizer, and shoe covers located next to the backdoor on the patio.

Off-Limits Outdoors
Licensee stated that the garage door is made inaccessible to children with a padlock.

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. The parent board is located in the family room and includes the facility license, Emergency Disaster Plan, and Notification of Family Child Care (PUB394). LPA also observed a First-Aid Kit located in the kitchen and a 2A10:BC fire extinguisher (serviced on 2/2021) installed in the kitchen. LPA observed a fire alarm in the family room and a functioning smoke/carbon monoxide detector in the hallway.

Discussed topics:
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).
[CONTINUE ON PAGE 3]

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

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: FULLER FAMILY CHILD CARE	FACILITY NUMBER: 197494401
	VISIT DATE: 06/04/2021

NARRATIVE

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SIDS & Shaken Baby Syndrome Awareness. Licensee was reminded that all infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome), and to prevent the Shaken Baby Syndrome, Never shake a baby!

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.

Parent’s Rights Notification. The "Notification of Parent's Rights" (PUB394) was discussed with the licensee and the licensee was advised that it must be posted in an area of the home accessible to parents. Title 22 102419.

Nutrition Requirement. Licensee was made aware of AB 290, commencing January 1, 2016, requiring 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. Health & Safety Code 1596.8661.

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

LPA advised Licensee to follow and remain updated with COVID-19 guidelines.

[CONTINUE ON PAGE 4]

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

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: FULLER FAMILY CHILD CARE	FACILITY NUMBER: 197494401
	VISIT DATE: 06/04/2021

NARRATIVE

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Licensing Reports Given to Parents Required. 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. Assembly Bill 633.

Incidental Medical Services Awareness. 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, Website: www.ada.gov/childqanda.htm
Facilities that provide Incidental Medical Services (IMS) must identify those services in their facility’s Plan of Operation and submit an updated Plan of Operation to the Department. 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.

An exit interview was conducted with Licensee on 5/4/2021 at 10:25AM and a copy of this report (LIC809) was sent to Licensee via email. Licensee agreed to reply to the email in lieu of a signature.

SUPERVISOR'S NAME: Maureen Neal	TELEPHONE: (424) 301-3042
LICENSING EVALUATOR NAME: Lillian J Casillas	TELEPHONE: (424) 301-3097
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021

LIC809 (FAS) - (06/04)

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