198012858-8-27-2021-54-CC-SSAZ-C6ATDY-20210827143907

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198012858
Report Date: 08/27/2021
Date Signed: 08/27/2021 02:39:13 PM

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:	CLARK FAMILY CHILD CARE		FACILITY NUMBER:	198012858
ADMINISTRATOR:	CLARK, JAUNITTIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 502-0344
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90810
CAPACITY:	14	CENSUS: 3	DATE:	08/27/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:35 PM
MET WITH:	Juanitita Clark, Licensee		TIME COMPLETED:	03:00 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) Susann Sanchez conducted an unannounced annual random inspection to the above facility. Upon arrival, LPA met with Licensee, Juanita Clark, who guided LPA on a tour of the facility at 1:40PM. The licensee states that 2 adults currently live in the home. All adults present in the home have obtained a criminal record clearance or exemption prior to working, living, or volunteering in the licensed child care home. Per Licensee, there are 8 children that are currently enrolled. There was 1 child, 1 schoolage, and 1 infant present upon arrival. Licensee states there are 1 infant currently enrolled. LPA observed licensee is operating within the license capacity limitations. Licensee's hours of operation are Monday through Friday, 7:30am to 5:30pm. Per Licensee there are no firearms, weapons, pets, or bodies of water on the premises. LPA observed the Emergency Disaster Plan, Parent’s Rights Poster, and the Facility License were posted in the living room. A current children’s roster was available for review. This is a one story home which consists of 2 bedrooms, 1 bathroom, kitchen with dining area, living room, front yard, and backyard (fenced). Off limit areas include: 2 Bedrooms, detached garage and laundry room (locked). LPA inspected back yard and found the detached garage and laundry room locked. There are two wall heaters in the living room area and are barricaded. The licensee does provide food for children in care. All areas identified on the facility sketch that children use, were inspected for safety, comfort, telephone service (cell phone) , ventilation and heating (central). The following was observed and reviewed during this inspection. PHYSICAL PLANT Detergents, cleaning compounds, medications, and other items which could pose a danger are inaccessible to children. Licensee's state that all poisons and clean compounds are kept in a locked outside in garage.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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: CLARK FAMILY CHILD CARE	FACILITY NUMBER: 198012858
	VISIT DATE: 08/27/2021

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged. Per State Fire Marshall standards, fire extinguishers shall be serviced annually. Smoke and Carbon detector was tested and is operable. 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 06/15/2021. The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR which expire in 04/2022.

There is heating and ventilation for safety and comfort. There are toys available for children. The licensee states that there is a cell phone that is used and stays at the facility during operating hours.

At this time, children are using the back yard and front yard for outdoor play time. The licensee states that supervision is provided at all times.

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.

The following items were also discussed with licensee during this inspection.
PETS: There are no pets premises.
POSTING REQUIREMENTS: Emergency Disaster Plan, Parent’s Rights Poster and the Facility License are observed to be posted in the living room
PROHIBITED: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that falls into these categories are not permitted in a family child care facility. No sleeping children in CARSEATS. SMOKING IS PROHIBITED IN A LICENSED FAMILY CHILD CARE HOME.

LPA discussed Department of Public Health, Early Care and Education Guidance COVID-19 recommendations. PIN 20-24 was given and explained.

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SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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: CLARK FAMILY CHILD CARE	FACILITY NUMBER: 198012858
	VISIT DATE: 08/27/2021

NARRATIVE

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Infant Care: Licensee is caring for infants but will not care for infants under 12 months at moment but will in the future. LPA advised to sleep infants where they can be directly supervised at all times and advised against sleeping infants in a separate room. The licensee states the following as a supervision plan for infants: Licensees states that infants will sleep in the family room. LPA advised Licensee physically check on sleeping infants every 15 minutes and document whether there is labored breathing, signs of distress, and sleep position (on their backs) . Licensee has a camera in the infant nap room. LPA provided the Licensee with copy of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA went over in detailed PIN 20-24. Online copy can be downloaded a https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Incidental Medical Services (IMS):
The licensee states that she will provide IMS. 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 how to access forms, regulations and quarterly updates on line at: www.ccld.ca.govAB1207 Mandated Child Abuse Reporter training will expire on 02/18/ 2022.

Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing. (use LIC624B for written report). Licensees shall reveal each facility license number in all advertisements, publications, or announcements made with the intent to attract clients.

Based on the LPA’s observations and records review there are no deficiencies cited.
Exit interview was conducted with Licensee Juaniittia Clark . The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00. Exit interview was conducted with licensee. Appeal Rights were given and explained.

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Susann Sanchez	TELEPHONE: (323) 981-3366
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC809 (FAS) - (06/04)

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