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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198003055
Report Date: 05/18/2023
Date Signed: 05/18/2023 02:10:01 PM


Document Has Been Signed on 05/18/2023 02:10 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:ENNIS FAMILY CHILD CAREFACILITY NUMBER:
198003055
ADMINISTRATOR:ANGELA E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 632-9358
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY:14CENSUS: 3DATE:
05/18/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Angela Ennis, LicenseeTIME COMPLETED:
02:25 PM
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On 05/18/23, Licensing Program Analysts (LPA) Susann Sanchez conducted unannounced annual 1 year visit at 12:30pm. LPA met with Angela Ennis, Licensee who guided analysts on a tour of the facility. Also present was Licensee's assistants Rita Ruff and Maria Barajas. There were 3 children present during inspection. Facility capacity is in compliance for a Large Family Child Care Home. Per Licensee, hours of operation will be Monday through Friday, 6:00 am to 6:30 pm. Licensee states that she will care for children 0 to 13 years of age.

Tour began at 12:45pm. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, den/ day-care room, living room, garage with bathroom, backyard, and front yard. The children use the bathroom in the den, kitchen, backyard. Per licensee, areas off limits to children and parents include: all bedrooms, one bathroom, living room, front yard, garage with attached bathroom. The licensee provides food for children in care.

All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home.

All areas identified on the facility sketch that children use, were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating (central). The following was observed and reviewed during this inspection.

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 and the last drill conducted was 05/04/23. Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged. The home maintains telephone service via landland and cell phone. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:
DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/18/2023
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ENNIS FAMILY CHILD CARE
FACILITY NUMBER: 198003055
VISIT DATE: 05/18/2023
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LPA observed that detergents, cleaning compounds and medication are stored in the kitchen and is lathced, inaccessible to children. Licensee understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up is in the den away from the other children.

Currently Licensee cares for 1 infant. LPA reviewed the following with Licensee: napping equipment cannot block entrances or exits. Infant mattresses need to be firm with tightly fitted sheets. No loose objects, bumpers, objects hanging, or objects attached to the play yards or cribs. Each infant should have their own play yard and bedding. LPA review and left copies of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, and 15 minute sleep check documentation for infants 0-24 months.

Currently, children are using the backyard for outdoor play. LPA did not observe any objects that could be hazardous to children in care. LPA reminded Licensee that when children are outside, visual supervision is required at all times. There are no pools or spas, or other bodies of water.



Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15 minute Infant Sleep Check (0-24 months was explained and an advisory was given).

Staff records were reviewed for approved Pediatric First Aid and CPR certification (expires 06/07/23), LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunization, TB clearance or risk assessment, and current Mandated Reporter Training Certificate (expires 01/14/24).

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Licensee 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.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
Page: 3 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: ENNIS FAMILY CHILD CARE
FACILITY NUMBER: 198003055
VISIT DATE: 05/18/2023
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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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

Based on the LPA's observations and records review no deficiencies will be cited today. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Licensee A. Ennis.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann SanchezTELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023
LIC809 (FAS) - (06/04)
Page: 4 of 4