198002408-8-5-2021-54-CC-RNAO-C5LUTB-20210805155139

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198002408
Report Date: 08/05/2021
Date Signed: 08/05/2021 03:51:51 PM

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:	LEWIS, SONIA C. FAMILY DAY CARE		FACILITY NUMBER:	198002408
ADMINISTRATOR:	LEWIS, SONIA CALUNSOD		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 549-9809
CITY:	CARSON	STATE: CA	ZIP CODE:	90745
CAPACITY:	14	CENSUS: 7	DATE:	08/05/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:10 PM
MET WITH:	Sonia C. Lewis		TIME COMPLETED:	04:11 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 (LPAs) Raul Navarro and Lilli Babcock conducted an unannounced annual inspection. LPAs arrived at 2:10pm and met with Licensee Sonia C. Lewis who guided LPAs on a tour of the facility. Also present was Licensee's assistant. There were seven children present during today’s inspection. Licensee states that there are currently 11 children enrolled. The Licensee is within the conditions, limitations, and capacity specified on the license. The children's roster was reviewed and is current. This is a one story home which consists of three bedrooms and three bathrooms. Areas used by the children include the den/playroom, one restroom, kitchen, dining area, living room, and front yard. Per Licensee, areas off limits to children and parents include: three bedrooms, two restrooms, and backyard. Outdoor play area is fenced. The Licensee uses the living room as the designated ill isolation area. At 2:30pm LPAs observed a men's razor shaver inside a plastic container in a drawer in the restroom. This is a potential risk to the health and safety of the children in care. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone service maintained in the home. The open face fireplace is screened to prevent access to children. All adults present have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee has a pet dog. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Poisons are locked, as required. Per Licensee, there are no weapons, firearms or bodies of water on the premises. There are safe toys, play equipment and materials observed for children. Emergency Disaster Plan was posted at the time of inspection. The valve on the required 2A 10BC fire extinguisher indicates fully charged, last purchased 08/04/2021. Report continues- Page 1 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

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 4

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: LEWIS, SONIA C. FAMILY DAY CARE	FACILITY NUMBER: 198002408
	VISIT DATE: 08/05/2021

NARRATIVE

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Smoke and carbon monoxide detectors were tested and are in operable condition. The Licensee has current EMS approved Pediatric First Aid and CPR, which will expire on 12/2021. Proof of immunization against influenza, pertussis, and measles for the Licensee and Assistants was readily available during today’s inspection. The Licensee has not taken the mandated reporter due to training not being available in their primary language.

Licensee states that she is currently caring for one infants. Licensee states that infants sleep in the den room where they are constantly supervised. Appropriate sleeping arrangements and cribs were observed. Play yard did not hinder the entrance or exit from the sleeping space. Play yards were observed to be free of loose articles and objects. LPAs did not observe any infants swaddled while in care. LPAs advised the Licensee that infants shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15 minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant up to 12 months of age. A copy of the LIC 9227 was provided to Licensee.

The following was discussed: 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 clearances prior to initial presence in the home will result in an immediate $100.00 dollar or more per day Civil Penalty. The Licensee shall be present in the home and shall ensure that children in care are supervised at all times. Children shall not be left in parked vehicles.

Rooms that are off-limits need to be made inaccessible during operating hours. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. Infant walkers, johnny jumpers, saucer chairs, trampolines and any other item that falls into that category are not permitted in the facility. Car seats shall only be used for transportation purposes and shall not be used for sleeping. 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 2 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: LEWIS, SONIA C. FAMILY DAY CARE	FACILITY NUMBER: 198002408
	VISIT DATE: 08/05/2021

NARRATIVE

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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

Children’s Records were reviewed to ensure that Identification and Emergency form and a medical assessment are on file. At 3:15pm, Child #7 did not have an ID and Emergency Form. LPA issued the Confidential Names List (LIC 811) to the licensee during this visit. The Confidential Names List documents the children’s files that were reviewed during this inspection.

The deficiencies listed on the following page were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Licensee Sonia C. Lewis. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Report ends- Page 3 of 3

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

LIC809 (FAS) - (06/04)

Page: 4 of 4

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: LEWIS, SONIA C. FAMILY DAY CARE	FACILITY NUMBER: 198002408
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/05/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/05/2021 Section Cited	1 2 3 4 5 6 7	102417- Operation of a Family Child Care home(g)(4) Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement was not me as evidenced by LPAs
	8 9 10 11 12 13 14	observations. LPAs observed a razor shaver inside a drawer in the bathroom. The razor was inside a plastic container. This is a potential risk to the health and safety of the children in care.	8 9 10 11 12 13 14
Type B 08/12/2021 Section Cited	1 2 3 4 5 6 7	102417- Operation of a Family Child Care Home (g)(7 )- An emergency information card shall be maintained for each child and shall include the child's full name, telephone number and location of a parent or other responsible adult to be contacted in an emergency, the name and telephone number of the child's
	8 9 10 11 12 13 14	physician and the parent's authorization for the licensee or registrant to consent to emergency medical care. This requirement was not met as evidenced by file review. Child #7 did not have an ID and emergency form on file. This is a potential risk to the health and safety of the children in care.	8 9 10 11 12 13 14

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: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul Navarro	TELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

LIC809 (FAS) - (06/04)

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