197494958-3-9-2022-30-CC-LCLN-CCD3BR-20220309170645

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494958
Report Date: 03/09/2022
Date Signed: 03/09/2022 05:06:53 PM

Document Has Been Signed on 03/09/2022 05:06 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:	HAMPTON FAMILY CHILD CARE		FACILITY NUMBER:	197494958
ADMINISTRATOR:	DEANNA HAMPTON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 403-2099
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90008
CAPACITY:	14	CENSUS: 0	DATE:	03/09/2022
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	DEANNA HAMPTON, LICENSEE		TIME COMPLETED:	01:00 PM

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On 03/09/2022 at 09:45am, Licensing Program Analyst (LPA) Lisa Clayton conducted an announced Pre-licensing Site Inspection with Licensee Deanna Hampton for an ANNOUNCED RELOCATION INSPECTION. Present for the inspection was licensee, there were no children in care. The home was toured with the licensee for a health and safety inspection. Hours of operation are Monday through Sunday 6am to 6pm.

This is a one-story home which consists of the following rooms: 2 bedrooms, 1 full bathroom and a ½ bath, living room, formal dining room, kitchen, laundry room, family room, den, backyard and detached garage. The home is neat and clean with heating and ventilation for safety and comfort. The licensee has requested the OFF LIMIT AREAS are as follows: living room, both bedrooms, the full bath, and laundry room which will be inaccessible by child safety gates, closed and/or locked doors and visual supervision. The Licensee has requested the following rooms be ON LIMITS: the formal dining room (play/eating area), kitchen/dining area, family room (little kids room), den (Pre-School room) and the backyard. The ISOLATION AREA will be in the Pre-School room. The backyard play area is completely fenced. The fireplace is in the living room and inaccessible to children by a child safety gate. Per licensee, there are no firearms in the home. A copy of the lease/deed/mortgage statement was reviewed and shows control of property.

There are toys and learning materials present at the facility during today's inspection. There are no pools, hot tubs or any other bodies of water on the premises.

The home has a fully charged 3A:40:BC fire extinguisher, working smoke detector/ carbon monoxide detector, and working telephone. The home was cleared by the LA City Fire Department on 12/14/2021 and there is a pull-down fire alarm system on the back wall of the Pre-School room. The licensee’s Health and Safety training is completed and CPR and First Aid certificate is current and expires on 06/2023. The licensee's mandated reporter training is complete and she received a certificate of completion on 8/20/2021. The licensee is in compliance with the immunization law which pertains to day care providers.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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: HAMPTON FAMILY CHILD CARE	FACILITY NUMBER: 197494958
	VISIT DATE: 03/09/2022

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LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

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, available at: http://www.ada.gov/childqanda.htm

California Law requires Family Child Care Home licensees to report unusual incidents or injuries to children in care to child's parents and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or electronic mail. Roster of the children must be properly maintained and fire/disaster drill every six months must be documented.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

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: HAMPTON FAMILY CHILD CARE	FACILITY NUMBER: 197494958
	VISIT DATE: 03/09/2022

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Licensee is reminded that ALL assistants, volunteers, frequent visitors, or adults living in the home, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Licensee was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

For licensing updates email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list.

The licensee is reminded any structural changes to the home or additions to the child care facility must be reported to Community Care Licensing. Licensee was reminded of Departments inspection authority, with our without any notice.

This home is recommended for licensing as of 03/09/2022. Exit interview conducted and report was reviewed with the Licensee, Deanna Hampton.

SUPERVISOR'S NAME: Mary Ruiz	TELEPHONE: (424) 301-3061
LICENSING EVALUATOR NAME: Lisa Clayton	TELEPHONE: (424) 301-3206
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022

LIC809 (FAS) - (06/04)

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