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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008545
Report Date: 02/18/2020
Date Signed: 02/18/2020 09:49:31 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:ALLEN-WILLIAMS FAMILY CHILD CAREFACILITY NUMBER:
198008545
ADMINISTRATOR:ALLEN-WILLIAMS,KATRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 630-6100
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 4DATE:
02/18/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Katrina Allen-WilliamsTIME COMPLETED:
10:00 AM
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Licensing Program Analyst (LPA) Warren Birks conducted an unannounced random inspection. LPA met with Licensee Katrina Allen-Williams. Upon arrival, LPA observed the Licensee caring for two preschool children. Two more preschool children arrived later. There are 14 children enrolled.

This is a one story home which consists of 3 bedrooms, 1 1/2 bathrooms, living room, kitchen, dining room, and family room. Per licensee, areas off limits to children and parents include: two bedrooms, one bathroom, and garage. Primary care takes place in living room, dining area, bathroom located near the kitchen, and 1 bedroom used for dramatic activity and the backyard.

All areas used by children were inspected for safety, comfort, cleanliness, ventilation and heating (central). The licensee states that there are no poisons in the home. The licensee understands that any poisons must be locked with a key or combination lock. Detergents, cleaning compounds, medicines, sharp objects were inaccessible. Per licensee, there are no weapons, firearms or bodies of water on the premises. There are appropriate toys observed for children. The Licensee's 2A 10BC fires extinguisher is fully charge (in the green) and is due for service January 2021. Smoke and carbon monoxide detectors in the kitchen were tested and are in operable condition. Licensee also has ADT fire protection and surveillance cameras. There are emergency supplies on the premises and a first aid kit.



LPA observed outdoor play area to be free of hazards at this time. LPA advised Licensee that fire grills may be allowed in the backyard with a cover to make inaccessible to children.

The licensee understands that in her absence a qualified adult individual who has a valid and current adult/infant CPR & Pediatric First Aid certification and a valid criminal record clearance (associated to the facility) can care for children. The licensee's CPR expires in October 19, 2021. LPA observed children's files contain Identification and Emergency forms, Immunization Records and Parent's Rights.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
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: ALLEN-WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198008545
VISIT DATE: 02/18/2020
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There were NO ZERO TOLERANCE deficiencies cited during this visit. Zero Tolerance includes:
Absence of Supervision; Accessible Bodies of Water. No bodies of water on the premises; Accessible Firearms, Ammunition or Both. No firearms or weapons in the home; Refused Entry to a Facility or Any Part of a Facility in Violation of Section 1596.852, 1596.853 or 1597.09. Regulations 101238 (g)(2); The Presence of an Excluded Individual. No excluded individuals; Children are not left in parked vehicles.

POSTING REQUIREMENTS: Parent’s Rights Poster, Facility License and Emergency Disaster Plan is posted. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME. 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.

INFANT CARE: LPA advised the licensee to sleep infants where the infant can be directly supervised. If the licensee chooses to sleep infants in another room, the licensee is advised to conduct periodic checks. LPA discussed the following. 1) Safe Sleeping Poster (www.sidsandkids.org), Sudden Infant Death Syndrome (SIDS) and Never-Shake-a-Baby were discussed.

Medication: 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.

UPDATE: H&S 1597.622: 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. All adults have the required immunizations.

Beginning January 1, 2018, Health and Safety Code 1596.8662 requires all licensed providers, applicants, directors, and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Volunteers are encouraged but not required to take the training.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
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: ALLEN-WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198008545
VISIT DATE: 02/18/2020
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Effective January 1, 2018: Existing licensees must meet requirements by March 30, 2018. Preventive (OCAP) online training modules are free of cost and available at http://www.mandatedreporterca.com/. Licensee and staff provided the evidence of the required 1/1/18 Mandated Reporter Training.

LPA provided Licensee with a Capacity and Ratio handout and The Effects of Lead exposure handout
LPA informed licensee of Items not permitted in Licensed facility (Napping Rockers, bouncers, car seats).

LPA also advised Licensee to always ensure that items such as medicines, perfumes, cosmetics, mouth wash, shampoos, lotions, sharp objects and hazardous items are always inaccessible to children. Inaccessibility means locked away or out of reach (placed in a high storage area inaccessible to children).

The Notice of Site Visit (LIC 9213) and Licensing Report– 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 $100.00 civil penalty. Exit interview conducted with Licensee Katrina Allen-Williams.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2020
LIC809 (FAS) - (06/04)
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