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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017888
Report Date: 08/10/2022
Date Signed: 08/10/2022 04:01:40 PM


Document Has Been Signed on 08/10/2022 04:01 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:WILLIS FAMILY CHILD CAREFACILITY NUMBER:
198017888
ADMINISTRATOR:WILLIS, LA CREASHIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 481-5556
CITY:LONG BEACHSTATE: CAZIP CODE:
90805
CAPACITY:14CENSUS: 12DATE:
08/10/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Licensee - La Creashia WillisTIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA) R. Derraco conducted an unannounced required one year inspection to the above facility on 08/10/22. LPA arrived at the facility at 1:25PM and met with licensee, La Creashia Willis, who guided analyst on a tour of the facility. Also present during this inspection was assistant S2 and S3. Per Licensee, there are 18 children that are currently enrolled. There were 12 children present upon arrival.

This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen/dining room, living room, a detached garage, front yard and backyard (fenced). The off limit areas include 3 bedrooms, 1 bathroom, kitchen, front yard, and detached garage.

The main care area is located in living room. LPA observed napping cots, a sectional couch, a cubby locker for children's personal belongings, art supplies, a pull down fire alarm and a ceiling fan. The dining area has also been converted to be used for children in care. LPA observed a Graco playpen, age appropriate toys, additional art supplies, additional sleeping cots, and a wall mounted television. Per licensee, the space is used for infants, however no infants were in attendance today. The bathroom designated for children in care was observed to be clean and have an operable toilet and sink. Baby gate was observed at the entrance to the off limits kitchen. The outdoor play area is located in the backyard. Per licensee, children are taken through the front door through the side entrance into the backyard play area. The backyard play area was observed to have perimeter fencing. Outdoor play equipment, a swing/slide structure, and adequate shade were observed in the backyard play area. The licensee states that she provides food for children in care. Per licensee, isolation area for children showing signs of illness will be located in the dining room or outside while awaiting parent pick up. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. LPA observed two pet dogs that are kept in the off limits area of the home. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:
DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/10/2022
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 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: WILLIS FAMILY CHILD CARE
FACILITY NUMBER: 198017888
VISIT DATE: 08/10/2022
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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 cellphone that is used and the cellphone stays at the facility during operation hours. Per Licensee, the home is equipped with central heating and air conditioning. Detergents, cleaning compounds, poisons and other items which could pose a danger to children were observed to be locked in a cabinet located in off limits area of the backyard. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 07/03/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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 First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 06/2023 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 -
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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC809 (FAS) - (06/04)
Page: 4 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: WILLIS FAMILY CHILD CARE
FACILITY NUMBER: 198017888
VISIT DATE: 08/10/2022
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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 La Creashia Willis

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SUPERVISOR'S NAME: Trevino CochranTELEPHONE: (323) 981-3385
LICENSING EVALUATOR NAME: Randy DerracoTELEPHONE: (323) 981-3431
LICENSING EVALUATOR SIGNATURE:

DATE: 08/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/10/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5