198005917-7-6-2022-54-CC-WBIS-CG3RUG-20220706131956

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198005917
Report Date: 07/06/2022
Date Signed: 07/06/2022 01:20:03 PM

Document Has Been Signed on 07/06/2022 01:20 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:	BATH FAMILY CHILD CARE		FACILITY NUMBER:	198005917
ADMINISTRATOR:	BATH, DEBBIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 896-3536
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	14	CENSUS: 3	DATE:	07/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Debbie Bath		TIME COMPLETED:	01:30 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) Warren Birks conducted an unannounced Required 1 Year inspection. LPA met with Licensee Debbie Bath who guided LPA on a tour of the facility. Upon arrival LPA observed the Licensee and cleared assistant caring for three preschool children. There are 12 children enrolled attending the facility. All residents associated with the facility were noted. All areas identified on the facility sketch were inspected. This is a single story home with three bedrooms, one bathroom, living room, two bedrooms (nap rooms), restroom, recreation room, front yard, side yard. The Licensee uses a recreation room, the front enclosed yard, the side yard, the bathroom and the dining area for care. Areas off-limits to children is one bedroom and half of an enclosed front yard. The recreation room is detached from the home and no eating or sleeping takes place in the room. At 12:30pm LPA provided Licensee with Entrance forms, Items not permitted and form regarding capacity and ratio. Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. Between At 11:30am and 12:00pm LPA observed age appropriate toys and play equipment inside the home and in the backyard. The backyard is surrounded by gates and their is a small locked shed used for storage. There is a working telephone maintained in the home. LPA observed one medium sized pet that remains in an off-limits. LPA observed detergents, cleaning compounds, medications, and other items which can pose a danger to children to be inaccessible (locked in cabinets or high above ground). LPA informed Licensee that poisons must be locked with a key or combination lock. Per Licensee there are no firearms, weapons or bodies of water and LPA did not observe any on the premises. The License, Parents Rights poster, and Earthquake Preparedness was posted. The children's roster and Disaster drill is current (last date of drill February 8, 2022. The required 2A 10BC fire extinguisher has a guage in the green and is due for service in August 2022. The Licensee's CPR is current and must be renewed by September of 2022. Continued

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

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: BATH FAMILY CHILD CARE	FACILITY NUMBER: 198005917
	VISIT DATE: 07/06/2022

NARRATIVE

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LPA observed the Licensee and cleared Assistant have current Mandated Reporter training which expires in 2023. LPA also observed that the Licensee and staff have documentation indicating immunization regarding measles, pertussis and tuberculosis on file.

LPA reviewed three children's files to be in compliance. The files included the following documentation: Parent's Rights, Personal Rights, Affidavit for Liability insurance, Identification and Emergency, Consent for Emergency Treatment, Additional Children in Care and Immunization records.

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. LPA advised to ensure all adults that come into the home are fingerprint cleared and associated.

No smoking, No infant walkers, No Johnny jumpers, No saucer chairs, No trampolines and any other item that falls into that category are not 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. Licensee CPR expires September 2022.

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

LPA 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 document the child's condition. The LIC 9227 Individual Infant Sleeping The plan shall be completed for each infant up to 12 months of age. LPA explained form is available on CCLD website. The Licensee was advised on the inaccessibility of hazards, Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. LPA informed Licensee regarding PIN 20-24-CCP.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: BATH FAMILY CHILD CARE	FACILITY NUMBER: 198005917
	VISIT DATE: 07/06/2022

NARRATIVE

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LPA discussed LIC 311D - Forms/Records to Keep in Your Family Child Care Home. Mandatory Forms for the children’s files and staff files, requirements for fire drills, earthquake drills and documentation were discussed. Role and responsibilities of being a Mandated Reporter were reviewed. The Licensee was advised how to access forms and Regulations online at www.ccld.ca.gov. Licensee was made aware that it is his/her responsibility to know the regulations as well as anyone who assists in providing care.

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 which always Baby is sleeping on his/her back. Capacity Handout (Small & Large) was provided during this inspection. Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing (use LIC624B for written report). Mandated reporter training must be completed every 2 years. www.mandatedreporterca.com.

LPA provided Licensee with Safe Sleep PIN 20-24-CCP also discussed Covid Self Assessment and Covid safety according to the Los Angeles County Health Department.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. This report along with a copy of the appeal rights was provided. Exit interview was conducted with Licensee Debbie Bath.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 07/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/06/2022

LIC809 (FAS) - (06/04)

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