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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494401
Report Date: 05/16/2024
Date Signed: 05/16/2024 12:43:42 PM

Document Has Been Signed on 05/16/2024 12:43 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:FULLER FAMILY CHILD CAREFACILITY NUMBER:
197494401
ADMINISTRATOR/
DIRECTOR:		CLAUDETTE FULLERFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 528-6517
CITY:GARDENASTATE: CAZIP CODE:
90247
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
05/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Claudette FullerTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On May 16, 2024, Licensing Program Analyst, V. Wheatley conducted an unannounced Annual Inspection and was met by Licensee's daughter Sania Harris. LPA observed 10 day care children present upon arrival and one more child arrived during the inspection. The licensee arrived at 9:50am Days and hours of operation are currently Monday-Friday 6am to 7:30pm. The licensee explained that she had a major water leak and damage to the day care room and has relocated the children to the attached garage temporarily. LPA observed the children supervised by licensee's daughter and assistant Martha Franco.

LPA toured the home inside and outside and a census was taken. Current facility sketch confirmed that the rear family room is used for day care. However, because of the emergency the children are in the attached garage. The kitchen is currently off limits and the licensee is using a microwave, toaster oven to cook food. All bedrooms are off-limits and made inaccessible by use of locks. There is no swimming pool or other bodies of water on the premises. There is a firearm on the premises per licensee which is locked in a safe and no ammunition. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible. There is a working fire extinguisher, smoke detector, and carbon monoxide detector. There is central heating and air conditioning for ventilation. There are no stairs in the home. Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number.

LPA discussed Safe Sleep Regulations with licensee. Cribs and play yards will be kept free from all loose articles and objects while infants are sleeping, and there are 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. There are two infants on the premises. LPAs observed the current children's roster.
Maureen Neal
Veronica Wheatley
DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2024
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: 05/16/2024
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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. The licensee does not transport children. The outdoor play area in the backyard is fenced and there are no hazards present. The yard will not be used until the construction in the home is completed. There are 3 dogs on the premises which are inaccessible to the day care children. Capacity as specified on the license is being maintained.

LPAs reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training expires 3/19/2025 and 4/11/2025. Licensee’s pediatric CPR/First Aid expires on 9/2025 and assistant expires 4/2026. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. Licensee conducts fire drills with the children and uses a sounding device.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA discussed with the licensee the Community Care Licensing website www.ccld.ca.gov which will provide access to Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations. Licensee is receiving P.I.N.S.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

This report shall be made available to the public upon request. LIC 9213 Notice of Site Visit is provided and required to be posted for 30 days.

Exit interview conducted. A copy of the report was read and provided to the licensee.
SUPERVISOR'S NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 05/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2024
LIC809 (FAS) - (06/04)
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