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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198008545
Report Date: 03/08/2023
Date Signed: 03/08/2023 03:10:30 PM


Document Has Been Signed on 03/08/2023 03:10 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
MONTEREY PARK S WEST, 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: 12DATE:
03/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Licensee - Katrina WilliamsTIME COMPLETED:
03:25 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) R. Derraco conducted an unannounced required one year inspection to the above facility on 03/08/23. LPA arrived at the facility at 12:20 PM and met with Licensee, Katrina Williams, who guided analyst on a tour of the facility. Also present during this inspection was an assistant and husband. Per Licensee, there are 20 children that are currently enrolled. There were 9 children present upon arrival. LPA observed 3 additional children arriving to the home at 2:25 PM

This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, a den, laundry room, attached garage, front yard and backyard (fenced). The off limit areas include 2 bedrooms, one bathroom, garage, and front yard.

The main care area is located in the living room. LPA observed several sensory toys, art materials, storage cabinets for children, a wall mounted television, child sized table and child sized chairs. LPA observed a Graco pack and play in the den along with 5 theater style chairs, two wall mounted televisions, a desk and a infant changing station. The kitchen was observed to have locks on all cabinets and drawers. No sharp or pointy objects were observed to be accessible in the kitchen area. Per licensee, she provides food for the children in care. The bedroom was also observed to have additional toys, reading material, art supplies and sleeping cots. The bathroom was observed to be clean with an operable sink, toilet, and faucet. Per licensee, the outdoor play area is temporarily off-limits due to the recent rain storms. LPA observed outdoor play equipment stored beneath the shaded area of the backyard. Licensee states that she will make backyard accessible to children when the rain storms have passed. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the main care area. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. Per licensee, isolation area for children showing signs of illness will be located in the bedroom designated for children in care while (page 1 of 3)
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2023
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 3


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ALLEN-WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198008545
VISIT DATE: 03/08/2023
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
they await parent pick up. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. No bodies of water were observed in the back yard play area. There are no pets on the premises.

Individuals who reside in the home were noted and discussed. 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. 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 a land line. Per Licensee, the home is equipped with central heating and air conditioning. Day care area was observed with safe toys, play equipment and materials.

Detergents, cleaning compounds, and other items which could pose a danger to children were observed to be locked in upper cabinet in the off-limits laundry room. Per licensee, additional cleaning products are kept in the off-limits garage. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked, not just inaccessible. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 07/14/22 as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

Safe sleep guidelines were discussed with licensee. LPA discussed the safe sleep regulations with licensee [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 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.

The licensee and other personnel have completed training on preventive health practices including Pediatric
(page 2 of 3)
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ALLEN-WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198008545
VISIT DATE: 03/08/2023
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
First Aid and CPR. The licensee's Pediatric First Aid and CPR expires 01/08/24. LPA observed that the Licensee and assistant do have proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Katrina Williams-Allen.

(page 3 of 3)

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
LIC809 (FAS) - (06/04)
Page: 3 of 3