198005602-1-24-2020-54-CC-RNAO-BL5RUJ-20200124122000

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198005602
Report Date: 01/24/2020
Date Signed: 01/24/2020 12:20:12 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:	LAKESHORE KIDS & COMPANY		FACILITY NUMBER:	198005602
ADMINISTRATOR:	MARTHA BASS-NICHOLS		FACILITY TYPE:	830
ADDRESS:	2695 E. DOMINGUEZ ST.		TELEPHONE:	(310) 537-8600
CITY:	CARSON	STATE: CA	ZIP CODE:	90895
CAPACITY:	14	CENSUS: 4	DATE:	01/24/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Kathy Jewel		TIME COMPLETED:	12:20 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) Raul Navarro conducted an unannounced random inspection. LPA met with designated Co-Director, Kathy Jewel, who guided LPA on a tour of the facility. This is an infant program licensed for 14 infants. The facility operates Monday – Friday from 6:30 AM – 6:00 PM. Per the Co-Director there are 14 children enrolled. The infant program is physically separate from the other components at this facility both indoors and outdoors. All areas identified on the facility sketch were inspected. Upon arrival, LPA observed four children with three staff. Teacher - infant ratios were observed to be in accordance with Title 22 regulations. The facility is within the conditions, limitations, and capacity specified on the license. Staff names were recorded. All children were observed to be under visual supervision of a teacher at all times. Classroom was observed to ensure that infants are never left unattended and under the direct visual supervision of a staff person at all times. The facility was inspected to ensure that it is clean, safe, sanitary, and in good repair to ensure the safety and well being of children, employees and staff. Furniture and equipment was inspected for good repair, free of sharp, loose, or pointed parts. The facility has age appropriate furniture and equipment including but not limited to cribs, cots/mats, changing tables and feeding chairs. LPA observed that infant changing tables are within an arm’s reach of a sink. LPA observed sufficient infant napping equipment that meets the requirements of Title 22 regulations. LPA did not observe any baby walkers or any items that fall into that category present in the facility. Storage for medication was inspected to ensure that medications are in a safe place inaccessible to children. At this time, the office is used as an isolation area. There are portable cots and changing mats in the office. Parents are contacted immediately when children are determined to be ill. 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: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAKESHORE KIDS & COMPANY	FACILITY NUMBER: 198005602
	VISIT DATE: 01/24/2020

NARRATIVE

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Snack menus were reviewed to ensure that they are being posted at least one week in advance and visible to an authorized representative. The facility does have a food program, which provides food for all children enrolled. Some parents provide food for their children. Food is prepared at the facility. There is drinking water available both indoors and outdoors (Sippy cups) LPA observed that bottles, dishes, and containers of food brought by the infant’s authorized representatives are labeled with the infant’s name and current date.

All storage containers for solid waste, including moveable bins, have tight fitting covers on and are in good condition. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are stored in an area inaccessible to infants. Facility has one or more functioning carbon monoxide detectors that meet statutory requirements. The facility takes measures to keep the facility free of flies, other insects and rodents.

Outdoor play equipment was observed to be in good condition, free of sharp, loose or pointed parts. Outdoor activity space surface is maintained in a safe condition as is free of hazards. Areas around and/or under climbing equipment and slides have cushioning material to absorb a fall. The Co-Director states that there are no bodies of water on the premises and LPA did not observe any bodies of water during this visit.

Sign in and out sheets were reviewed to ensure that children present are signed in. Staff Records were reviewed to ensure that personnel records are maintained on all staff. Also to ensure that Teacher’s present have required infant units on file and are qualified. Criminal Records Clearance for adults and verification of CPR/First Aid and health preventative practices documentation was reviewed. All staff has proof of immunization against influenza, pertussis, and measles. All staff present has also taken the required Mandated Reporter Training. LPA provided the Co-Director with a copy of the LIC 859- Staff Records Review during today's inspection.

Children’s Records were reviewed to ensure that each child has a separate, complete, and current record, a Needs and Services Plan, and a medical assessment are on file. LPA provided the Co- Director with a copy of the LIC 857- Children's Record Review during today's inspection.

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: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

LIC809 (FAS) - (06/04)

Page: 2 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAKESHORE KIDS & COMPANY	FACILITY NUMBER: 198005602
	VISIT DATE: 01/24/2020

NARRATIVE

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This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. Tools Resources-Quarterly Updates-Child Care Program

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no citations being issued today.

Exit interview was conducted with Co-Director Kathy Jewel. The Co-Director 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: 01/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2020

LIC809 (FAS) - (06/04)

Page: 3 of 3