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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016399
Report Date: 05/24/2019
Date Signed: 05/24/2019 10:40:11 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:GRIFFIN FAMILY CHILD CAREFACILITY NUMBER:
198016399
ADMINISTRATOR:GRIFFIN, ARIANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 253-7559
CITY:LONG BEACHSTATE: CAZIP CODE:
90804
CAPACITY:14CENSUS: 7DATE:
05/24/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Ariana GriffinTIME COMPLETED:
10:55 AM
NARRATIVE
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Licensing Program Analysts (LPA) Warren Birks conducted an unannounced random inspection. LPA met with Licensee Ariana Griffin and cleared adult. Upon arrival, LPA observed 7 children (4 preschool, 3 infants). There are 10 children enrolled. The Licensee's spouse left the facility and the facility was out of ratio having seven children (four being infants) with no assistant.

This is a 1 story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room (no FIREPLACE), garage and backyard (fenced). The children use the living room, middle bedroom, back bedroom, bathroom and backyard for daycare. The garage is not used for daycare. Per licensee, areas off limits to children and parents include: One bedroom and one bathroom. The LPA toured all areas used by children during this visit. The wall heater has a barrier and the outdoor play area appears to be free of hazards.

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 ire inaccessible. LPAs observed an empty baby bouncer and car seat in the daycare area (Licensee removed).. 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 and required service June 2019. Smoke and carbon monoxide detectors in the living room were tested and are in operable condition. There are emergency supplies on the premises and a first aid kit.



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 September 2020. LPA observed children's files containing Identification and Emergency forms, Immunization records and Parent's Rights.
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
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: GRIFFIN FAMILY CHILD CARE
FACILITY NUMBER: 198016399
VISIT DATE: 05/24/2019
NARRATIVE
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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. 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 has the required 1/1/18 Mandated Reporter Training.

LPA informed licensee of Items not permitted in Licensed facility (Napping Rockers, bouncers, car seats, saucer chairs).

LPA also advised Licensee to always make ensure that items such as medicines, perfumes, cosmetics, mouth wash, shampoos, lotions are always inaccessible to children. Inaccessibility means locked away or out of reach if they are placed in a high storage area (5 feet or higher).

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. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon their return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled child for the next 12 months. A signed Acknowledgement of Receipt (LIC9224) shall be in each child’s file, acknowledging receipt. Exit interview conducted with Licensee Griffin.

SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
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: GRIFFIN FAMILY CHILD CARE
FACILITY NUMBER: 198016399
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/24/2019
Section Cited
CCR
102416.5
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Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.
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Licensee to remove saucer chair
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 LPAs observed accessible saucer chair. This poses a potential risk to children in care.
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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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
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: GRIFFIN FAMILY CHILD CARE
FACILITY NUMBER: 198016399
VISIT DATE: 05/24/2019
NARRATIVE
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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.

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).

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.



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.

Licensee was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP’s direct contact information is as followed:
Phone number: (916) 654-1541 Email Address: childcareadvocatesprogram@dss.ca.gov
SUPERVISOR'S NAME: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
LIC809 (FAS) - (06/04)
Page: 3 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: GRIFFIN FAMILY CHILD CARE
FACILITY NUMBER: 198016399
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/24/2019
Section Cited
CCR
102416.5
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If no assistant provider is present at a Large Family Child Care Home, then the licensee shall comply with the capacity requirements for a Small Family Child Care Home as specified in subsections (b) and (c). This requirement was not met as evidenced by: Licensee had eight children (4 infants and 4 preschool) with no assistant present.
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Licensee indicated she will have have an assistant available.
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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: Brandi VanOostenTELEPHONE: (323) 981-3365
LICENSING EVALUATOR NAME: Warren BirksTELEPHONE: 323-981-3373
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2019
LIC809 (FAS) - (06/04)
Page: 4 of 5