198004510-2-9-2022-33-CC-NTCG-CBGRX8-20220209122420

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198004510
Report Date: 02/09/2022
Date Signed: 02/09/2022 12:24:31 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	JONES FAMILY CHILD CARE		FACILITY NUMBER:	198004510
ADMINISTRATOR:	JONES, WILLIAM & LISA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 796-1386
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	14	CENSUS: 0	DATE:	02/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Lisa & Bill Jones - Licensees		TIME COMPLETED:	12:35 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 Analyst (LPA) Nolan Tcheng conducted an unannounced annual random inspection to the above facility. Upon arrival at 10:45am, LPA met with licensees, Lisa and Bill Jones. The licensee states that they currently has 9 children enrolled. A current children’s roster is available and is current. Licensee’s hours of operation are 12:30-5pm, Monday-Friday. Licensee prefers to care for school age children, ages 5-12 yrs old. This is a one-story duplex which consists of Converted garage, 2 bathrooms, kitchen, living room, play room 1, play room 2, front yard and backyard (fenced). The children use all areas of the property. Per licensee, areas off limits to children and parents include: the front housing unit. The licensee provides food for children in care. The licensee states that 2 adults and 0 children currently live in the home. Licensees states that they currently do not have an assistant. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. Per licensee, there are no weapons, firearms or bodies of water on the premises. PHYSICAL PLANT At 10:50am, LPA was lead on a tour of the facility by the licensees. The tour began in the facility's converted garage where LPA observed a restroom for children to use as well as storage containers labelled with children's names. The attached portion of the converted garage had age appropriate play equipment and bicycles. Per licensees, they will go on bicycle rides with the children daily around the neighborhood. LPA observed bicycle helmets The tour continued into the living room of the facility. The facility was clean, orderly, and free of any defects. LPA observed age appropriate toys and games for the children. LPA observed play rooms 1 and 2. There were napping mats observed but per licensees, due to children's age and time spent at the facility each day, they do not do nap time. REPORT CONTINUES PAGE 1 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

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 3

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: JONES FAMILY CHILD CARE	FACILITY NUMBER: 198004510
	VISIT DATE: 02/09/2022

NARRATIVE

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The licensee states that there is a land line on the premises. At 11am, Smoke and carbon monoxide detectors were tested and are operable. There is a wall heater in the hallway that LPA observed to be emptied of its operational hardware. LPA observed the indoor restroom for children which was safe, clean, and operational. Next to the restroom and front door, there was a parent board where Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted. The kitchen was observed to be free of sharp knives or utensils. Per licensees, detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children and were observed to be locked under the kitchen sink. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked with a key or combination lock. At 11:07am, a fire extinguisher was observed. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 02/26/2021, as indicated on service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. There are first aid supplies available. Per licensee, play room 2 will be used as an area for an ill child until an authorized representative comes to pick up child. A mat is available. At 11:10am, LPA observed the front and back yard area. The outdoor play area was observed to be fenced. At this time, children are using the front and back yard for outdoor play time. The licensee is observed to be operating within the license capacity limitations.

FACILITY RECORDS:

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 04/2022. Licensee and other personnel have complete mandated reporter training that expires on 08/06/2022. The licensees do have proof of immunization against influenza, tuberculosis, pertussis, and measles. Children’s record were reviewed, including but not limited to, a copy of the emergency information card that contains all the information specified by regulation.

The following was discussed: -Individuals who are 18 years of age or older living in the home must be finger print cleared prior to being in the presence of the children in care. Individuals within one month of their 18th birthday must be fingerprinted immediately.

-There are no pets on the premises.
-Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility.
-Smoking is prohibited in a license family child care home.
REPORT CONTINUES PAGE 2 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: JONES FAMILY CHILD CARE	FACILITY NUMBER: 198004510
	VISIT DATE: 02/09/2022

NARRATIVE

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Infant Care: Licensee states that they are not caring for infants. LPA advised the licensee if they do, to sleep infants where they can be directly supervised at all times and advised the licensee against sleeping infants in a separate room. LPA provided the licensee with a copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics and Helping you to reduce the risk of SIDS. LPA consulted and explained Child Abuse Reporting, Updated Parent’s Rights Poster with Complaint Hotline information, Never Shake a Baby, Sudden Infant Death Syndrome (SIDS), and Safe Sleeping practices. PIN 20-24-CCP was provided and explained during the inspection.

Incidental Medical Services (IMS):

The licensee states that she will provide IMS. Per licensee, there are no children enrolled that require IMS at this time. 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.

During this inspection LPA discussed PIN 20-06 CCP, Social And Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Coronavirus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education and reviewed Child Care Covid-19 Self Assessment.

LPA advised the licensee how to access forms, regulations and quarterly updates on line at: www.ccld.ca.gov. AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com/

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative.

Exit interview was conducted with Lisa and Bill Jones, Licensees, 12:!5pm, including a copy of report.

REPORT ENDS PAGE 3 of 3

SUPERVISOR'S NAME: Claudia Guangorena	TELEPHONE: (323) 981-3417
LICENSING EVALUATOR NAME: Nolan Tcheng	TELEPHONE: (323) 240-6201
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

LIC809 (FAS) - (06/04)

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