198001123-6-4-2024-54-CC-ACAN-D5WRKH-20240604130533

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198001123
Report Date: 06/04/2024
Date Signed: 06/04/2024 01:05:49 PM

Document Has Been Signed on 06/04/2024 01:05 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	BEEZER & SHAW FAMILY CHILD CARE		FACILITY NUMBER:	198001123
ADMINISTRATOR:	BEEZER, CYNTHIA M.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 537-8022
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY:	14	CENSUS: 6	DATE:	06/04/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:			TIME COMPLETED:	01:15 PM

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	Licensing Program Analysts (LPA) Ashley Calderon conducted unannounced annual random inspection. LPA met with Licensee Cynthia Beezer. LPAs disclosed the purpose of the inspection and was granted entry into the facility by Licensee. Licensee who guided analyst on a tour of the facility, inside and outside of the facility premises. There was 2 infants and 5 children present during inspection. There was one assistant present at the home. Facility capacity is in compliance for a Large Family Child Care Home. Per Licensee, hours of operation are Monday through Friday 6:00 am to 6:00 pm and does not to exceed 24 hour care at one time. Per Licensee will extend hours if needed depending on the child age and parents schedule. Licensee cares for children Infants -12 years of age. This is a two story home which consists of 6 bedrooms, 4 bathrooms, kitchen, dining room, living room, family room, garage and backyard with a pool (fenced). Primary care / areas for children take place in a converted garage (play room area), sitting room used to care for after-school children and children eating area, den used for nap/rest and two bathrooms. Per Licensee all other areas are off limits to children and parents. All areas identified on the facility sketch that children use, were inspected for safety, comfort, cleanliness, telephone service (mobile and land line present), ventilation and heating (central). All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. LPA reviewed all individuals present in the home and reviewed that all individuals have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. LPA advised Licensee and assistant eating and napping should not take place in the garage (play room area). The following was observed and reviewed during this inspection: (Page 1, Continuation LIC809-C...)

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

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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Document Has Been Signed on 06/04/2024 01:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BEEZER & SHAW FAMILY CHILD CARE	FACILITY NUMBER: 198001123
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on LPA observation during record review, the licensee did not comply with the section cited above in [1] out of [2 ] persons which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Licensee will have assistant staff get immunizations stated above including TB and submit to LPA Claderon via email by POC due date.

Type B

Section Cited

CCR

102418(a)

Immunizations

(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation during record review LPA did not observe Child #2 immunization records, Per licensee needs to obtain immunization from child's parent, the licensee did not comply with the section cited above in [1] out of [6] persons which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Licensee will obtain immunization records for Child #2 and send to LPA via email by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 06/04/2024 01:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BEEZER & SHAW FAMILY CHILD CARE	FACILITY NUMBER: 198001123
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(c)

Infant Safe Sleep

An Individual Infant Sleeping Plan [LIC 9227 (3/20)] shall be completed for each infant up to 12 months of age the provider has in care and included in the infant's file at the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review LPA did not observe Indiv. Infant Sleep Plan for Child #2, per Licensee was unable to provide form to LPA Calderon, Per licnsee interview Child #2 does not have form completed, the licensee did not comply with the section cited above in [1] out of [2] persons which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Per Licensee will have Child #2 parent fill out form and will submit to LPA by POC due date.

Type B

Section Cited

CCR

102425(j)(2)(D)(c)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation during record review no sleep log kept for Child #2 and Child #3, Per licensees interview stated not keeping records for infants sleep, the licensee did not comply with the section cited above in [2] out of [2] persons which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Per Licensee will start sleep log starting 6/4/24 , LPA provided a sleep log sample to use if Licensee would like and licensee was advised that to continue for each infant (24 months and younger) enrolled. Will provide sleep log records to LPA by POC due date.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

Page: 3 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BEEZER & SHAW FAMILY CHILD CARE	FACILITY NUMBER: 198001123
	VISIT DATE: 06/04/2024

NARRATIVE

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Smoke and carbon monoxide detectors were tested and are operable. The home is observed to be clean and orderly. Fire extinguisher was observed, charged and service date 1/12/23, inspections are done yearly and /or per licensee stated purchases a new extinguisher yearly. LPA advise to keep receipt as proof. LPA observed there are toys and other age appropriate material available for children inside and in the backyard. Off limit area are sectioned off with baby gate. LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 5/08/24, Per licensee, prefers to conduct drills yearly. All forms were located in the garage upon entrance on the right hand side. Per Licensee stores chemicals out of reach in the hallway closet inaccessible to children in care. Per Licensee, Licensee states that there poisons stored in the off limit up stairs part of the home and understands that all poisons must be lock, not only inaccessible to children. Per Licensee there are no firearms or weapons stored in the home. Per licensee, there is a pet dog in the home, dog does not mingle with the children to prevent safety and ensure safety to the children in care. Outside play area was observed. There is a shaded area for children to play. LPA observed a pool that children have no access too, there is a wall and locked gate blocking the pool area from the children's outdoor play space.

LPA reviewed (5) children's records, Child #2 and Child #3 are infants, Licensee was unable to provide Child #2 Individual Safe Sleep Plan and immunization records and Child #2 and #3 Sleep Log Records, deficiencies cited. LPA reviewed Safe Sleep Infant Regulations for infant's safety, and reviewed required infant documentation's for infants files. LPA reviewed Licensee records, CPR expires 6/14/24 and Mandated Reporter Training Expires 6/9/24 and LPA reviewed assistant present records, per record review LPA observation: Mandated Report Training and Immunization records not in file, per Licensee will have assistant complete required documentation's, deficiencies cited.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

(Page 2, Continuation 809-C...)

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BEEZER & SHAW FAMILY CHILD CARE	FACILITY NUMBER: 198001123
	VISIT DATE: 06/04/2024

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Based on LPA’s observations, interview and records review, the following deficiencies listed on the attached LIC 809-D (deficiency pages) are being cited in accordance with California Code of Regulations Title 22. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee Cynthia Beezer. (End or Report)

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

Page: 6 of 6

Document Has Been Signed on 06/04/2024 01:05 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BEEZER & SHAW FAMILY CHILD CARE	FACILITY NUMBER: 198001123
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/04/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

HSC

1596.8662(b)(1)

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation during record review LPA did not observe mandated reporter training for Assisant present, Licensee during interview stated did not know assisants needed training and assistant states with children while Licenee picks up children from school, the licensee did not comply with the section cited above in 1 out of 2 persons which poses an immediate health, safety or personal rights risk to persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Licensee will submit via email to LPA Calderon proof off Assistants Mandated Report Training Certifcate by POC due date. LPA provided website

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024

LIC809 (FAS) - (06/04)

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