<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008295
Report Date: 10/25/2019
Date Signed: 10/25/2019 10:19:25 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:GRAVES FAMILY CHILD CAREFACILITY NUMBER:
198008295
ADMINISTRATOR:GRAVES, TONNETTE'FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 480-2120
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:14CENSUS: 3DATE:
10/25/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
07:40 AM
MET WITH:Tonnete GravesTIME COMPLETED:
09:25 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) Raul Navarro conducted an unannounced random annual inspection. LPA met with Licensee Tonnette Graves who guided this LPA on a tour of the facility. Also present was Licensee's assistant.There were three children present during today’s inspection. Licensee states that there are currently 16 children enrolled. The children's roster was reviewed and is current. Disaster drill log was also available during today’s inspection.

This is a one story home which consists of three bedrooms and two bathrooms. Areas used by the children include the Living room, one bathroom, kitchen/dinning room, front yard, and side yard. Per Licensee, areas off limits to children and parents include: three bedrooms, one bathroom, backyard, and garage.

Areas accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. Family members residing in the home are two adults (criminal record clearances on file) and one child. Licensee has a pet dog. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Poisons are locked, as required. The Licensee does understand that poison must be locked with a key or combination lock.

Per Licensee, there are no weapons or firearms in the home. LPA did not or bodies of water on the premises. There are safe toys, play equipment and materials observed for children. Emergency Disaster Plan was posted at the time of inspection. Children’s records were reviewed to ensure that each child has an Identification and Emergency form. The valve on the required 2A 10BC fire extinguisher indicates fully charged. Per Licensee, it was last serviced over a year ago. Smoke detector was tested and is in operable condition. No carbon monoxide was observed in the facility. The Licensee does not have current Pediatric First Aid and CPR, which expired on 08/2019.
Report continues- Page 1 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 5
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: GRAVES FAMILY CHILD CARE
FACILITY NUMBER: 198008295
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/08/2019
Section Cited

1
2
3
4
5
6
7
Employee and Volunteer- Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This
8
9
10
11
12
13
14
requirement was not met as evidenced by file review. Licensee and assistant did not have proof of immunization during today's inspection. This is a potential risk to the health and safety of the children in care.
8
9
10
11
12
13
14
Type B
11/01/2019
Section Cited

1
2
3
4
5
6
7
On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training ... and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated
8
9
10
11
12
13
14
reporter training. This requirement was not met as evidenced by file review. Per licensee, assistant and herself have not taken the mandated reporter training as required. This is a potential risk to the health and safety of the children in care.
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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: GRAVES FAMILY CHILD CARE
FACILITY NUMBER: 198008295
VISIT DATE: 10/25/2019
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
26
27
28
29
30
31
32
Proof of immunization against influenza, pertussis, and measles for the Licensee and assistant was not readily available during today’s inspection. The Licensee and assistant have not taken the Mandated Reporter Training.

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.

Rooms that are off-limits need to be made inaccessible during operating hours. 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.

LPA reviewed and issued the 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.
The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed. A hard copy of "A Child Care Provider’s Guide to Safe Sleep" was provided.

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
Report continues- Page 2 of 3
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: GRAVES FAMILY CHILD CARE
FACILITY NUMBER: 198008295
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/01/2019
Section Cited

1
2
3
4
5
6
7
Personnel Requirements-The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid- This requirement was not met as evidenced by file review. Licensee's training certificate expired on 08/2019. This is a potential risk to the and safety of the children in care.
Type B
11/01/2019
Section Cited

1
2
3
4
5
6
7
Operation of a Family Child Care Home-The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirement was not met as evidenced by facility tour. Licensee stated fire extinguisher has not been serviced in over a year. This is a potential risk to the health and safety of the children in care.
Type B
11/01/2019
Section Cited

1
2
3
4
5
6
7
Carbon monoxide detectors required; inspection- Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8... Part 2 of Division 12. The department shall account for the presence of these detectors during inspections. This requirement was not
8
9
10
11
12
13
14
met as evidenced by the tour of the facility. Licensee did not have a carbon monoxide detector during inspection. This is a potential risk to the health and safety of the children in care.
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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: GRAVES FAMILY CHILD CARE
FACILITY NUMBER: 198008295
VISIT DATE: 10/25/2019
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
26
27
28
29
30
31
32
The licensee’s email address was obtained during this inspection. The licensee was advised that email is public information.

The deficiencies listed on the following pages were observed by the LPA and are being cited in accordance with California Code of Regulations Title 22. Please see attached LIC 809-D. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

Exit interview was conducted with Licensee Tonnette Graves. The Licensee was provided a copy of their appeal rights (LIC 9058) and their signature on this form acknowledges receipt of these forms.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site inspection by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

Report ends- Page 3 of 3

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Raul NavarroTELEPHONE: 323-981-3388
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019
LIC809 (FAS) - (06/04)
Page: 3 of 5