197494842-6-3-2021-30-CC-KMIL-C3MM6M-20210603092011

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494842
Report Date: 06/01/2021
Date Signed: 06/03/2021 09:24:21 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:	LE MAO FAMILY CHILD CARE		FACILITY NUMBER:	197494842
ADMINISTRATOR:	PIAH LE MAO		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	3105706839
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90230
CAPACITY:	14	CENSUS: 0	DATE:	06/01/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Piah Le Mao		TIME COMPLETED:	10:00 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 6/1/2021 at 8:30 am, Licensing Program Analyst (LPA) Kristina Mitchell conducted a tele-visit to the Le Mao Family Child Care Home for the purpose of conducting a Case Management inspection for a capacity increase. Due to Covid-19 the tele-inspection was conducted via FaceTime with licensee Piah Le Mao. The licensee has specified that she will operate from 8:30am -5:30pm, Monday - Friday, serving children 3 months to 3.5 years of age. The licensee was advised that during hours of childcare that the licensee shall be present in the home and shall ensure children in care are always visually supervised. Currently the residents of the home are the licensee and her husband. All areas identified on the facility sketch were inspected. The areas that were inspected were the dining/living room, play room, 4 bedrooms, 2 bathrooms, kitchen, area and the exterior of the facility. Licensee stated that main care will be conducted in the family room, living room, dining room and the designated exterior of the home that will be used for outdoor play. When entering the home you enter a shared space that is the living/dining room that contains 1 couch, 2 tables, a storage rack with 8 sleeping cots for children. A TV is on a console that is empty. Along the wall there is a bookshelf containing an older record player with albums. There is a closet door at the entry which only has a vacuum. This area is not off limits and will be used for additional children if necessary. Through the living room there are 2 entrances to the kitchen which are made inaccessible by 2 child proof entry gates. All cabinets and drawers are locked and latched with child safety devices. The garage entry door and a door leading to the backyard is in the kitchen and is off limits with child proof handles. Cleaning supplies are under sink and has a child proof lock on the doors. Licensee has stated that she will provide lunch 3 days a week and parents will provide lunch 2 days. Licensee will have extra food available for children if a child needs food. Page 1 of 7

SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 7

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: LE MAO FAMILY CHILD CARE	FACILITY NUMBER: 197494842
	VISIT DATE: 06/01/2021

NARRATIVE

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When exiting the kitchen to the right is the children’s playroom with a bookshelf with toys, 2 tables, block area, a light table, kitchen and playhouse area, and a storage bench with toys stored underneath.

Parents will enter from the side of the home and enter the playroom through sliding doors. A COVID-19 sanitation check-in station is located at entry parent information board with LIC documents were observed in this area. Exiting from the playroom leads to outdoor area containing bikes, 3 picnic style benches, a bookshelf with toys There is a fire pit that has been covered and made in accessible with a fitted wood covering and is used as a table. On the side of the home there are 3 storage units that have art supplies. This area leads to the front of the home which has a 6-foot latched gate. On the opposite side of the home there is a grass area that has a water table, block area and a rocking chair. On this side of the home there are 2 6-foot latched gates that are inaccessible for children to open.

When returning into the home through the playroom there is a hallway that leads to the main living areas of the home. To the left there are 2 cabinets used for storage that contain first aid supplies and towels. Bedroom 4 is next to the cabinets and this room is designated as the baby’s playroom. There are 2 bookshelves with toys and manipulative, a plush area and a changing table along the wall. The closet located in this room is used for storage of extra toys.

When returning to the hallway the first door on the left leads to bathroom 2 which the children will use. To the left is bedroom 3 which is off limits with child proof handle. Across the hall is bathroom 1 with cabinets that are locked and latched with child proof devices.

To the right of this bathroom is bedroom 1 that is designated as the babies sleeping room. There are 3 cribs, 1 chair and cubbies for storage of the children’s belongings. A sliding door closet contains blankets and additional storage items. To the left of this room is bedroom 2 which is off limits with a child proof doorknob.

The kitchen and bathroom cabinets and drawers are latched or locked with child proof devices to make sharp objects, medications, toxins, poisonous items and detergents inaccessible to children in care. LPA observed adequate materials and equipment that are age appropriate for children.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

Page: 2 of 7

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: LE MAO FAMILY CHILD CARE	FACILITY NUMBER: 197494842
	VISIT DATE: 06/01/2021

NARRATIVE

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A RAST assessment due to COVID-19 was conducted and additional materials were reviewed and emailed to licensee for posting. LPA observed postings throughout the home.

Licensee stated that there are no firearms kept on the premises. The fire extinguisher that is a 2A10BC is up to date and was serviced in May 2021. Licensee has smoke detectors located throughout the home in all rooms. The carbon monoxide detector is in the hallway and a fire alarm pull station is located in the main playroom. Cleaning items are made inaccessible with child proof locks and out of reach of the children on a top shelf in the laundry room. Licensee’s First Aid/CPR Training expires 11/2022.

Licensee has submitted an Emergency Disaster plan. The licensee has completed Preventive Health and Safety/Childhood Nutrition and Mandated Report training. Notification of Parents’ Rights Poster and Emergency Disaster Plan are posted.

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 clearance 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 3A-40BC must be serviced annually or as often as necessary and smoke and carbon monoxide detectors should be checked, and batteries replaced as needed.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

Page: 3 of 7

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: LE MAO FAMILY CHILD CARE	FACILITY NUMBER: 197494842
	VISIT DATE: 06/01/2021

NARRATIVE

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-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 once every six months for a Small FCCH and once every month for a Large FCCH and documented for review by the Department.

-Smoking is prohibited in a family childcare 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 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.

-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.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

Page: 4 of 7

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: LE MAO FAMILY CHILD CARE	FACILITY NUMBER: 197494842
	VISIT DATE: 06/01/2021

NARRATIVE

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The facility is 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, are available at: http://www.ada.gov/childqanda.html.

Per applicant, she does carry liability insurance or a bond in accordance with standard established by Family Child Care statue. Signed statements (LIC282) will be in children's files. The law requires Family Child Care provider to carry liability insurance or bond in the amount of $300,000 annually or to maintain the singed statement in the facility file.

LPA consulted and explained Child Abuse Reporting, Updated Patent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices which Baby is always 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 and Individual Infant Sleeping Plan LIC9227.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

Page: 5 of 7

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: LE MAO FAMILY CHILD CARE	FACILITY NUMBER: 197494842
	VISIT DATE: 06/01/2021

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 licensee 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 childcare 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.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: LE MAO FAMILY CHILD CARE	FACILITY NUMBER: 197494842
	VISIT DATE: 06/01/2021

NARRATIVE

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Senate Bill 792: This bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a childcare 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:

California Department of Social Services | Community Care Licensing Division

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 childcare 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 childcare center or family childcare 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.

An exit interview was conducted via Tele-Visit with Applicant, Piah Le Mao. A copy of this report was issued to the applicant. A copy of this report is being emailed to the applicant and it has been explained that a reply to the email shall be considered a substitute for the hard-copy signature.

The applicant will be granted a large family childcare license for a capacity of fourteen (14) pending review by Licensing Program Manager.

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SUPERVISOR'S NAME: Karren Starks	TELEPHONE: (310) 740-3038
LICENSING EVALUATOR NAME: Kristina Mitchell	TELEPHONE: (424) 301-3023
LICENSING EVALUATOR SIGNATURE:	DATE: 06/03/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2021

LIC809 (FAS) - (06/04)

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