198006228-8-27-2021-54-CC-DCHS-C6AP3N-20210827105750

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198006228
Report Date: 08/27/2021
Date Signed: 08/27/2021 10:57:58 AM

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:	HARBOR FAMILY CHILD CARE		FACILITY NUMBER:	198006228
ADMINISTRATOR:	HARBOR, YOLANDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 728-1056
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	14	CENSUS: 2	DATE:	08/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Yolanda Harbor, Licensee		TIME COMPLETED:	11:30 AM

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) Dayna Chambers conducted an unannounced annual inspection to the above facility on 08/27/21. LPA arrived at the facility at 09:00AM and met with Yolanda Harbor, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was licensee’s husband. Per Licensee, operation hours are 7:30am to 5:30pm Monday - Friday. There are 8 children that are currently enrolled. A current children’s roster was available for review. There were 2 children present upon arrival. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, front yard and backyard (fenced). The children use the bathroom in near the activity room by kitchen. LPA observed that there is a fireplace in the living room and it is screened. Per Licensee, areas off- limits to children and parents include: 3 bedrooms and one bathroom in master bedroom. The licensee provides food for children in care. Individuals who reside in the home were noted and discussed. Per Licensee, they currently do not have an assistant due to low enrollment. All adults present in the home have obtained a criminal record clearance or exemption prior to working, residing or volunteering in the licensed childcare home. Licensee states that there are no firearms stored in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via cell phone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating via central heat and air. Safe toys play equipment and materials were observed. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. These items are stored in the top cupboard above the refrigerator. The licensee understands that storage areas for poisons must be locked with a key or combination lock. The restroom that children use was observed to be safe and sanitary. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 06/25/21, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. Pg. 1

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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: HARBOR FAMILY CHILD CARE	FACILITY NUMBER: 198006228
	VISIT DATE: 08/27/2021

NARRATIVE

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Licensee states that she does not have any infants enrolled. Licensee states her preferred children’s age group served is 2 -10 years old. Licensee states that she will not enroll infants. LPA emailed the licensee a copy of the Provider Information Notice (PIN) 20-24 CCP: Recently Approved Safe Sleep Regulations in Effect.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did/did not observe any objects that can pose a danger to children on the outdoor yard.

The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

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 01/11/2023. There are first aid supplies available. LPA advised that if a child shows signs of illness he/she/they shall be separated from other children.

Children’s records were reviewed, including emergency information and were observed to be complete.

The licensee does have proof of immunization against TB, MMR, TDAP, declination letter for influenza.

LPA observed that the Licensee and assistant do/do not have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file.
LPA issued a Confidential Names List (LIC 811) to the licensee which documents staff and children’s files reviewed during this inspection.

All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill documented was conducted on 06/29/21.

There are birds and fish on the premises. LPA did/did not observe any pools, spas, hot tubs, fish ponds, or similar bodies of water during the inspection.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

Pg 2

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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: HARBOR FAMILY CHILD CARE	FACILITY NUMBER: 198006228
	VISIT DATE: 08/27/2021

NARRATIVE

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LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Incidental Medical Services (IMS):
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 to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

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

Exit interview was conducted with Yolanda Harbor, Licensee, including, but not limited to Appeal Procedures/appeal rights, Site Visit and agency’s consultative role.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna Chambers	TELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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