198007112-3-8-2022-54-CC-WBIS-CCBRAE-20220308115057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198007112
Report Date: 03/08/2022
Date Signed: 03/08/2022 11:51:12 AM

Document Has Been Signed on 03/08/2022 11:51 AM - 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:	TERRY FAMILY CHILD CARE		FACILITY NUMBER:	198007112
ADMINISTRATOR:	TERRY, JUDY DARLENE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 431-7471
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY:	14	CENSUS: 8	DATE:	03/08/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Judy Terry		TIME COMPLETED:	12:05 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 Judy Terry who guided LPA on a tour of the facility. Upon arrival LPA observed the Licensee and cleared assistant caring for three infants and five preschool children. There are nine children enrolled attending the facility on a part-time and full-time basis. All areas identified on the facility sketch were inspected. This is a single story home consisting of with three bedrooms, two bathrooms, kitchen, living room, back yard, and garage. The Licensee provides care in the living room, backyard and one bedroom (nap room) and one bathroom. Areas off limits to children in parents include two bedrooms, one bathroom, kitchen, side yard and the garage. At 8:45am LPA provided Licensee with Items not permitted and a form regarding capacity/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. At 8:55am LPA observed age appropriate toys and play equipment inside the home. At 9:00am LPA observed the kitchen and hallway to back bedrooms to be inaccessible by baby gates. The baby gates also prevent access to a wall heater in the hallway. There was no fire place observed in the home and the garage is inaccessible. At 9:10am LPA observed the backyard play area appear to be free of hazards and to be surrounded by gates that are higher than five feet. The garage is off limits and remains inaccessible. There is a working telephone maintained in the home. There are no pets in the facility. LPA observed Detergents, cleaning compounds, medications, and other items which can pose a danger to children to be inaccessible (kitchen is barricaded with baby gates and items in bathroom are high above ground). LPA informed Licensee that poisons must be locked with a key or combination lock. Per Licensee there are no firearms, weapons and bodies of water and LPA did not observe any. The Parents Rights poster and License are posted. The children's roster and Disaster drill is current (drill February, 2022. At 9:30am LPA observed the required 2A 10BC fire extinguisher's annual service is due August 2, 2022.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 03/03/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2022

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: TERRY FAMILY CHILD CARE	FACILITY NUMBER: 198007112
	VISIT DATE: 03/08/2022

NARRATIVE

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The Licensee and Licensee Mandated Reporter training expired 10/2/2020 and staff #1 must obtain Mandated Reporter training. At 9:30am LPA observed that the Licensee does not have Measles and Pertussis documentation and staff #1 does not have tuberculosis documentation on file.

At 9:45am LPA reviewed four children's files to be in compliance. The Files included items such as Individual Infant Sleeping Plans, Parent's Rights, Affidavit for Liability Insurance, Identification and Emergency, Consent for Emergency Treatment 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.

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

At 11:30am LPA informed Licensee of appropriate sleeping arrangements for infants. 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: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

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: TERRY FAMILY CHILD CARE	FACILITY NUMBER: 198007112
	VISIT DATE: 03/08/2022

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 Judy Terry

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/08/2022 11:51 AM - It Cannot Be Edited

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: TERRY FAMILY CHILD CARE	FACILITY NUMBER: 198007112
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/08/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as Licensee's Mandated Reporter expired 10/2/2020 and staff #1 does not have Mandated Reporter training. This poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/22/2022
	Plan of Correction
1 2 3 4	Licensee indicated she will provide evidence of Mandated reporter Training for her and staff #1.

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above as LPA observed that the Licensee does not have Measles and Pertussis documentation and staff #1 does not have tuberculosis documentation. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/08/2022
	Plan of Correction
1 2 3 4	Licensee indicated she will provide immunization documentation.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Karen Chambers	TELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren Birks	TELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC809 (FAS) - (06/04)

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