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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008186
Report Date: 09/06/2022
Date Signed: 09/06/2022 08:30:21 PM


Document Has Been Signed on 09/06/2022 08:30 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:WILLIS FAMILY CHILD CAREFACILITY NUMBER:
198008186
ADMINISTRATOR:WILLIS, LOLITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 208-5054
CITY:LONG BEACHSTATE: CAZIP CODE:
90804
CAPACITY:14CENSUS: 3DATE:
09/06/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Lolita Willis, LicenseeTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Dayna Chambers conducted an unannounced annual inspection to the above facility on September 6, 2022. LPA arrived at the facility at 2:00PM and met with Lolita Willis, Licensee who guided analyst on a tour of the facility. Also present during this inspection, was licensee’s spouse and volunteer. Per Licensee, operation hours Monday Through Thursday 6:00AM to 5:00Pm and Friday 6:00AM – 4:30PM. There are 9 children that are currently enrolled. A current children’s roster was available for review. There were 3 children present upon arrival. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, laundry room, living room, front yard and backyard (fenced) and attached garage which is converted into an activity room. LPA advised licensee about the temperature, ventilation, and reminded no napping or eating in the activity room. There is a back house with a different address and the tenant has a background clearance. The children use the bathroom in the hallway from the living room. The children use the living room, kitchen, dining room, and activity room. LPA observed that there is no fireplace. Per Licensee, areas off limits to children and parents include: 3 bedrooms and 1 master bathroom. The licensee provides food for children in care.Individuals who reside in the home were noted and discussed. Per Licensee, they currently have 7 qualified assistants. 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 cellphone that is used, and the cellphone stays at the facility during operation hours. There is ventilation and heating (central/open face observed to be screened/barricaded). 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. Poisons are locked in a cabinet in the laundry room and it is stored in the shelves. The laundry room is locked. The restroom that children use was observed to be safe and sanitary. Licensee has a brand-new fire extinguisher. The fire extinguisher receipt could not be located during inspection. The licensee will email the receipt by 09/07/22 to LPA. The valve on the required 2A 10BC fire extinguisher indicates fully
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna ChambersTELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2022
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: WILLIS FAMILY CHILD CARE
FACILITY NUMBER: 198008186
VISIT DATE: 09/06/2022
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charged. Smoke and carbon monoxide detectors were tested and are operable. Licensee states that she is not currently caring for infants. Licensee states that infants sleep in the dining room. Or Licensee states that if an infant is enrolled, the infant will sleep in the Dining Room where they are constantly supervised. A copy of the LIC 9227 was provided to Licensee. Currently, children are using the activity room (garage converted) and public parks or 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 not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided. The licensee is observed to be operating within the license capacity limitations. LPA did/did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did/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 06/05/2023. 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 has proof of immunization against influenza, pertussis, and measles but needs to organize records.. LPA observed that the Licensee and assistant 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 08/04/22. There are no pets on the premises. LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. 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 childcare facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. LPA provided the licensee with a copy of the Safe Sleep regulations. Incidental Medical Services (IMS): 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 Section 102417. 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.
SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna ChambersTELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022
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: WILLIS FAMILY CHILD CARE
FACILITY NUMBER: 198008186
VISIT DATE: 09/06/2022
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.A notice of site visit was given and must remain posted for 30 days.Exit interview conducted and report was reviewed with the licensee, Lolita Willis.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Dayna ChambersTELEPHONE: (323) 558-2962
LICENSING EVALUATOR SIGNATURE:

DATE: 09/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022
LIC809 (FAS) - (06/04)
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