198001806-2-8-2023-54-CC-KCHE-CNUT9V-20230208133233

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198001806
Report Date: 02/08/2023
Date Signed: 02/08/2023 01:32:53 PM

Document Has Been Signed on 02/08/2023 01:32 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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	FORD FAMILY CHILD CARE		FACILITY NUMBER:	198001806
ADMINISTRATOR:	YOUNG-FORD, LOUELLA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 762-6033
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	14	CENSUS: 7	DATE:	02/08/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Louella & Kenneth Ford, Co-Licensees		TIME COMPLETED:	01:50 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	On 02/08/2023 at 11:30 AM, Licensing Program Analyst (LPA)Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPA disclosed the purpose of the inspection and met with Co-Licensees, Louella & Kenneth Ford, who granted entry to facility and guided the LPA on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. Also present Licensee’s Assistants (A1 and A2). There was were four children and one infant upon arrival to facility, two more children arrived later totaling seven children present during today's inspection. Licensee states that there are currently 14 children enrolled. The children's roster was reviewed and is current. LPA observed required postings at time of inspection. Disaster drill log was available during today’s inspection, last disaster drill conducted on 02/06/2023. This is a two-story home which consists of five bedrooms and two bathrooms, Laundry Room, Kitchen, Dining Room, Living Room, Family Room, and converted garage. Areas used by the children include Bathroom 1 (located down the hallway towards rear of home), converted garage as Daycare Activity Space (located to the rear and right of the home), and Family Room (located in the rear of the home next to Daycare Space). Co-Licensees understand that converted garage is only to be used for Daycare Activity Space and cannot be used for napping or eating. LPA observed children eating in Family Room at time of inspection. Per Licensee, areas off limits to children and parents are front of the home which includes: Kitchen, Living Room, Laundry Room, Dining Room, Bedrooms 1, 2, and 3, and Bathroom 2; as well as all upstairs is off limits which includes rest of bedrooms (4 & 5). LPA observed that there is an operable baby gate separating areas used by children and off-limits area at time of inspection and a baby gate at foot of steps blocking access to upstairs. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. LPA observed ceiling fans and AC wall unit in areas used by the children. There is a working telephone maintained in the home. At 11:33 AM, LPA Report continues- Page 1 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

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 8

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: FORD FAMILY CHILD CARE	FACILITY NUMBER: 198001806
	VISIT DATE: 02/08/2023

NARRATIVE

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observed Bathroom 1 to have operable toilet and sink, adequate hand washing supplies, and general area safety and sanitation. LPA observed Bathroom 1 will require gate blocking access to upstairs to be opened, per Licensee children are fully supervised when using Bathroom 1. At 11:35 AM, LPA observed children in Daycare Activity Space with Licensee's Assistants. LPA observed child size tables and chairs well maintained and dramatic play toys, shelves with infant toys, stuffed animals, and other age appropriate toys, free of loose and sharp parts available for children. LPA observed a diaper changing table attached to the wall. LPA observed cabinets in Daycare Activity Space to be used for storage for more daycare materials. At 11:47 AM, LPA observed Family Room that children will use for napping to have large sofas, table, and kitchenette. LPA observed operable child safety locks on under cabinet sinks in Kitchenette. At 11:49 AM LPA observed there is a fireplace in the home in Family Room that is barricaded by a gate making it inaccessible. LPA observed standard blue mats stored in Daycare Activity Space used for children napping. Per A1, they also have a play pen used for napping for infants stored upstairs. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Per Licensee, these items are stored in off limits Laundry Room. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.

Per Co-Licensees, the children will have access to front yard for outdoor play. At 11:50 AM, LPA observed outdoor play area is accessible through a second door in Family Room. Per Licensee, children and families also enter facility through this door. LPA observed outdoor play area has adequate perimeter fencing through-out the yard. LPA observed large play structure with slide and swings well maintained with cushioning material below to absorb fall that is under shaded area. LPA provided technical assistance in regards to shade and how it is strapped. LPA observed bicycles, and other age appropriate toys free of loose and sharp parts available for the children in the outdoor play area.

Per Licensees, they provide food for children in care and also allow children to bring food from home.
Per Co-Licensees, there are no pets and LPA did not observe any pets at time of inspection. Per Co-Licensee, isolation area for sick children will be dependent on which area children will not be using at the time of care.

Per Co-Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises.
Report Continues - Page 2 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

Page: 2 of 8

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: FORD FAMILY CHILD CARE	FACILITY NUMBER: 198001806
	VISIT DATE: 02/08/2023

NARRATIVE

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At 11:45 AM, LPA observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag. At 11:47 AM, dual smoke and carbon monoxide detectors were tested and LPA observed are in operable condition at time of inspection. Per Licensee, First Aid kit is kept in the Daycare Activity Space, LPA observed First Aid kit was available. The Licensees have current Pediatric First Aid and CPR. Proof of immunization against influenza, pertussis, and measles was readily available during today’s inspection. The Licensees have also taken the Mandated Reporter Training
—CPR Card valid until: 01/07/2023 for Co-Licensees
—Fire Extinguisher was last serviced on: 09/2022
—Mandated Reporter AB1207 Completed: 06/02/2021 & 06/03/2021
—Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal record clearance requirement. LIC 126 was reviewed at inspection.

The following were discussed:
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

Licensee (or facility representative) was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility. Effective January 1, 2010, licensees of family child care homes are required to ensure that at least one staff member with current training in pediatric first aid and pediatric CPR is on site at all times when children are present.

Report Continues - Page 3 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

Page: 3 of 8

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: FORD FAMILY CHILD CARE	FACILITY NUMBER: 198001806
	VISIT DATE: 02/08/2023

NARRATIVE

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The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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.

AB 1207: Beginning on January 1, 2018, this law 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: http://www.mandatedreporterca.com/

The facility was found in compliance per Title 22 regulations, there will be no deficiencies cited only advisories given today on 02/08/2023.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with the Licensees (or facility representative), Louella & Kenneth Ford.

Report Ends - Page 4 of 4

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Katrina Chicote	TELEPHONE: (323) 629-7658
LICENSING EVALUATOR SIGNATURE:	DATE: 02/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023

LIC809 (FAS) - (06/04)

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