198007291-5-24-2019-54-CC-TFIS-BCGQ4Q-20190524115042

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198007291
Report Date: 05/24/2019
Date Signed: 05/24/2019 11:50:53 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:	MEYERS FAMILY DAY CARE		FACILITY NUMBER:	198007291
ADMINISTRATOR:	MEYERS, ALMA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 841-8403
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90815
CAPACITY:	14	CENSUS: 10	DATE:	05/24/2019
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	09:54 AM
MET WITH:	Alma Meyers		TIME COMPLETED:	12:09 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	REQUIRED INSPECTION CONDUCTED IN ENGLISH A Required inspection was conducted by Licensing Program Analyst (LPA), Timothy Fields. LPA was guided on a tour of the facility by Licensee, Alma Meyers. This is a single story home with four bedrooms and two bathrooms. Licensee's two assistants, licensee's aunt Yong Hui Hiser, adult son, and 10 day care children were present during today's inspection. Ms. Hiser was observed in an off limits bedroom with no children in her presence. Per licensee, Ms. Hiser arrived this morning and will be picked up at approximately 11am. Ms. Hiser planned to stay in the home from 5/24 - 5/27 during non-operating hours. Care is provided in the living room. The kitchen and dining room is accessible through passing. The first two bedrooms and guest bathroom located in the hallway are accessible. The remaining two bedrooms in the hallway and adjacent to the living room is off limits. Children do not have access to the master bath. LPA observed a barricaded fireplace in the living room. There were no pets or wall heaters observed. The front yard is off limits while the backyard is used for outdoor activity space. LPA observed a locked detached shed. Children have no access to the garage. All rooms that are off-limits need to be made inaccessible during operating hours. LPA observed the home to be kept clean and orderly, with heating and ventilation for safety and comfort. Capacity and ratio was observed to be in compliance. Licensee complied with inspection authority.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019

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: MEYERS FAMILY DAY CARE	FACILITY NUMBER: 198007291
	VISIT DATE: 05/24/2019

NARRATIVE

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Per licensee there are no weapons or firearms in the home. Telephone service was in operable condition. There are no *swimming pool or spa on the premises. The backyard is adequately fenced. There are age appropriate toys and equipment on the premises. The smoke detectors, carbon monoxide detector, and fire extinguisher (2A 10BC) are in operable condition.

-Pediatric CPR and First Aid expires:4/2021.
-Child Care Roster, Disaster Plan, and Children's Records were discussed.
-Children records and required licensing forms were discussed as well as mandated child abuse reporting and criminal records clearance (finger prints and child abuse clearance) requirement.
- Per licensee, the day care is covered under the homeowner's insurance.
- Licensee and assistant have completed the mandated reporter training.

The following was discussed: Individuals who are 18 years of age or older living or working in the home must be finger print cleared prior to licensure or living/working in the facility. Individuals within one month of their 18th birthday must be fingerprinted immediately. An immediate $100 per day Civil Penalty for a maximum of five days for the first violation and a maximum of 30 days for subsequent violations per individual will be issued. If an individual has a clearance with the Department, a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

During operating hours no smoking, no infant walkers, Johnny jumpers, Exersaucers and any other item that falls into that category are allowed in the facility. Earthquake, fire disaster, and safety drill posting requirement were explained in detail on this date.

Licensee has been advised of the following:
· Pools should be inaccessible by a pool cover or a 5-foot fence around the perimeter of the pool. If the fence is made out of chain link, the opening should not allow a golf ball to pass through. Fences made out of mesh will need to be approved by the department. Mesh fence will remain in place whenever licensed care is provided, and as long as the mesh fence makes the swimming pool inaccessible to children as determined by licensing staff.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019

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: MEYERS FAMILY DAY CARE	FACILITY NUMBER: 198007291
	VISIT DATE: 05/24/2019

NARRATIVE

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· Pool cover label should read F1346-91 American Society for Testing Material and it should be able to withstand the weight of an adult without water above cover when standing.
· Dog(s) and or pets should be isolated from children in care.
· It is recommended that a First Aid kit be available on premises.
· Outdoor supervision required at all times. If outdoor area not adequately fenced provider must be with children at all times when outdoors.

The following deficiencies are cited in accordance with Title 22 of California Code of Regulations and discussed with licensee:

Licensee's aunt Yong Hui Hiser was present in the home without a criminal record clearance.
Licensee's wooden play structure was loose and leaning to the right. It is a potential hazard to children.
Licensee has cleaning compounds underneath an unlocked kitchen sink cabinet.

See 809 D attached.

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. Required measles, pertussis, and influenza vaccinations were discussed.

Exit interview conducted with licensee. Appeal Rights provided and explained. Notice of Site Visit must be posted for (30) days. Failure to do so may result in a $100.00 civil penalty.
Web site address to order forms: http://www.dss.cahwnet.gov/cdssweb/On-lineFor_293.htm#l
INTERNET ADDRESS: http://www.ccld.ca.gov – To access licensing forms, updates and Title 22.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019

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: MEYERS FAMILY DAY CARE	FACILITY NUMBER: 198007291
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/24/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/24/2019 Section Cited CCR 102370(d)(1)	1 2 3 4 5 6 7	Criminal Record Clearance: Obtain a California clearance or a criminal record exemption as required by the Department. The requirement is not met as evidenced by licensee's aunt Yong Hui Hiser being present in the	1 2 3 4 5 6 7	Licensee states Ms. Hiser will be picked up and not return during operating hours. A POC inspection will be conducted to ensure Ms. Hiser is not in the home.
	8 9 10 11 12 13 14	home without a criminal record clearance.	8 9 10 11 12 13 14
Type B 05/31/2019 Section Cited CCR 102417(g)	1 2 3 4 5 6 7	Operations of a Family Child Care Home. The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: The requirement is not met as evidenced by	1 2 3 4 5 6 7	Licensee states a new lock will be placed on the kitchen cabinet and the wooden play structure will be removed by POC date 5/31/19. Pictures will be submitted as proof.
	8 9 10 11 12 13 14	LPA observing licensee's wooden play structure was loose and leaning to the right. It is a potential hazard to children. Licensee has cleaning compounds underneath and unlocked kitchen sink cabinet.	8 9 10 11 12 13 14

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: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Timothy Fields	TELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:	DATE: 05/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019

LIC809 (FAS) - (06/04)

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