198019637-5-8-2024-54-CC-ACAN-D53QE3-20240508120539

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019637
Report Date: 05/08/2024
Date Signed: 05/08/2024 12:05:47 PM

Document Has Been Signed on 05/08/2024 12:05 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MADISON-OWENS FAMILY CHILD CARE		FACILITY NUMBER:	198019637
ADMINISTRATOR:	TERRI MADISON-OWENS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 486-3702
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	14	CENSUS: 3	DATE:	05/08/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Terri Madison-Owens/ Licensee		TIME COMPLETED:	12:15 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) Ashley Calderon and Licensing Program Manager (LPM) Valarie Cook conducted an unannounced annual inspection at the above facility. LPA and LPM met with the Licensee Terri Madison-Owens and LPA and LPM disclosed the purpose for the inspection and was granted entry into the facility by the Licensee. LPA provided the inspection Entrance Checklist (LIC 126). Licensee guided LPA and LPM on a tour of the facility. Facility operation days/ hours are Monday through Friday 7:30 AM to 4:30 PM. This is a one story home which consists of three bedrooms and two bathrooms. Per Licensee, on limits areas for children include the family room, living room (day-care room), one restroom, laundry room, kitchen/dining room, front yard and half of the backyard (fenced). Per Licensee, areas off limits to children include: 3 bedrooms, one bathroom, billiard area, bonus room, detached garage inaccessible to children, and half of the backyard.LPA observed the off limits section of the backyard to have a locked gate that separated from accessible areas to the children. Children use the restroom located between the laundry room and an off limits bedroom. LPA observed play yard for infants and sleeping cots in the day care room. All areas identified on the facility sketch that are accessible for children to use were inspected for safety and comfort. The following was observed and reviewed during this inspection: LPA reviewed required posted documentation for Facility License and were observed to be posted by the day care entrance, Facility records were reviewed for LIC 9040- Facility Roster, LIC 610A- Emergency Disaster Plan and Verification of Disaster and Fire Drills. Per Licensee, drills are done quarterly and the last drill was conducted on 4/19/24. There is an operable carbon monoxide detector and a smoke detector in the home. A fully charged Fire extinguisher (2A10BC) was observed and last serviced on 4/14/24. (Page 1, Continuation 809-C...)

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MADISON-OWENS FAMILY CHILD CARE	FACILITY NUMBER: 198019637
	VISIT DATE: 05/08/2024

NARRATIVE

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LPA observed cleaning compounds inaccessible to children in care and sharp objects such as knives located in the kitchen area inaccessible to children in care. Per licensee there are no poisons stored in the home. LPA advised Licensee that all poisons must be locked away and inaccessible. Per Licensee there are no firearms or weapons stored in the home. Per Licensee, no children require medication.
Food is provided by Licensee for children ages 1 and above. LPA advised Licensee if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated.

There are toys and other age-appropriate materials available for children. LPA observed a fireplace in the living room made inaccessible to children in care. The outdoor play area was observed to be fenced and contain toys and other age- appropriate materials available for children. Per Licensee, children are supervised while playing outside. LPA did not observe any pools, spas, or other bodies of water. During the inspection, children present were observed to be treated with dignity and respect, observed to be receiving safe, healthful, and comfortable accommodations, furnishings, and equipment, and free from corporal and/or unusual punishment.

LPA reviewed records staff and children records. Two children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant Sleep Log. LPA provided consult to Licensee on the Infant Sleep regarding: LIC-9227 Individual Infant Sleeping Plan

Staff record(s) were reviewed for approved Pediatric First Aid/CPR certification which expires on 5/20/25 and Mandated Reporter Training Certificate was completed on 3/14/24. Individuals residing in the home have been discussed and noted.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

(Page 2, continuation 809-C...)

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MADISON-OWENS FAMILY CHILD CARE	FACILITY NUMBER: 198019637
	VISIT DATE: 05/08/2024

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS. Based on today’s visit, Per Regulations Title 22 there facility was found in compliance, and no citations were given.

A notice of site visit was given and must remain posted for 30 days.Exit interview conducted and report was reviewed with the licensee Terri Madison-Owens.
(Page 3 , End of Report)

SUPERVISOR'S NAME: Valarie Cook	TELEPHONE: (323) 513-3858
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2024

LIC809 (FAS) - (06/04)

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