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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017649
Report Date: 09/14/2022
Date Signed: 09/14/2022 12:12:09 PM


Document Has Been Signed on 09/14/2022 12:12 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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754



FACILITY NAME:GUILLORY FAMILY CHILD CAREFACILITY NUMBER:
198017649
ADMINISTRATOR:GUILLORY, BEATRICEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 849-5947
CITY:LOS ANGELESSTATE: CAZIP CODE:
90059
CAPACITY:14CENSUS: 0DATE:
09/14/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Beatrice Guillory, LicenseeTIME COMPLETED:
12:15 PM
NARRATIVE
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On 8/17/22 LPA Mooberry attempted an Annual Inspection. On 9/14/22 Licensing Program Analyst (LPA) Alicia Mooberry conducted an annual Inspection at 9:30 and met with Beatrice Guillory, Licensee. LPA explained the purpose of inspection and provided the inspection Entrance Checklist, LIC 126. LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access. Per licensee the hours of operation are Monday-Friday 6:00am - 6:00pm. There were no children present. Licensee stated they don't have children enrolled. Individuals living in the home were discussed and noted, All adults confirmed to live in the home by licensee have been cleared and associated.

This is a single story home that consists of 4 bedrooms, 2.5 bathrooms, kitchen, dining room, living room, laundry room, attached 2 car garage (with 1/2 bathroom) and front yard. The children use the attached garage and 1/2 bathroom for primary activity room. Licensee confirmed that garage is used only for activities and no eating or sleeping done in this area. The living room is used for feeding the children and napping. The garage has a portable air conditioning unit and was observed to be comfortable.

Per licensee, the areas used by children include: the living room inside the home the attached 2 car garage, half bathroom in the garage and yard accessed from the garage.

Off limit areas are: 4 bedrooms, 2 bathrooms. Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. Rooms that are off-limits need to be made inaccessible during operating hours. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. The licensee provides food for children in care.

LPA observed the facility license posted in the garage entrance. Licensee was provided with an updated Publication (PUB) 394- Notification of Parent Rights Licensee has no children enrolled and was reminded to maintain a current LIC 9040- Facility Roster. Licensee has the LIC 610- Facility Disaster Plan on file.

Page 1 – Report Continues

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022
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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Document Has Been Signed on 09/14/2022 12:12 PM - It Cannot Be Edited

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: GUILLORY FAMILY CHILD CARE
FACILITY NUMBER: 198017649

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
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 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that the carbon monoxide was not found in the daycare activity room which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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Licensee stated they will purchase and install the carbon Monoxide detector in the children's activity room. Licensee will profide proof of correction to LPA by email by POC due date.
Type B
Section Cited
CCR
102417(g)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and licensee confirmation, the licensee did not comply with the section cited above in that the living room where children nap was observed to be full of items including weights, a treadmill, and other boxes covering the floor where children would normally nap and eat. (There are no children currenly enrolled) which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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Licensee will clear out the items and boxes from the the living room and provide photo proof of correction via email by POC due date.

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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/14/2022 12:12 PM - It Cannot Be Edited

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: GUILLORY FAMILY CHILD CARE
FACILITY NUMBER: 198017649

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/14/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that the fire extinguisher did not have a service tag which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/14/2022
Plan of Correction
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Per licensee, the fire extingusher will be replaced by POC due date. Licensee will send a picture by email
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 09/14/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/14/2022
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: GUILLORY FAMILY CHILD CARE
FACILITY NUMBER: 198017649
VISIT DATE: 09/14/2022
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Smoke and carbon monoxide detectors were observed in the home, however, not available in the garage where children have activities, Per licensee, they will install smoke and carbon monoxide detectors in the garage/activity room. Fire extinguisher indicated fully charged, no service tag was available. Licensee was reminded that fire extinguisher needs to be serviced yearly. Licensee stated they have not operated due to COVID and will ensure the smoke and carbon monoxide detectors are installed in the garage/activity room as well as purchase a new fire extinguisher.

The home maintains telephone service via cell phone. There are toys and other age appropriate material available for children. LPA observed that cleaning compounds are in locked cabinet under the sink in the garage inaccessible to children. Licensee was reminded to ensure the cabinet locks are regularly inspected to ensure children don't have access to cleaning compounds. Licensee was reminded to regularly check for detergents and cleaners are inaccessible to the children in the laundry area located next to the entrance to the garage/daycare activity room. The home is observed to be clean and orderly. The bathroom that children use is located in garage and observed to be clean and free of hazards.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children.


Isolation area for sick children waiting to be picked up is in living room, away from the other children.

LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP. Licensee states infants sleep in the living room, each infant has their own crib or play yard where they are supervised at all times.

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.

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SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
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: GUILLORY FAMILY CHILD CARE
FACILITY NUMBER: 198017649
VISIT DATE: 09/14/2022
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The outdoor play area was observed to be fenced and cemented with age appropriate toys and other materials for children to play with LPA did not observe any objects that could be hazardous to children in care. Facility does not have a pool or similar bodies of water.

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

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.



To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee, Beatrice Guillory

SUPERVISOR'S NAME: Valarie CookTELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Alicia MooberryTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2022
LIC809 (FAS) - (06/04)
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