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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020553
Report Date: 02/29/2024
Date Signed: 04/03/2024 09:30:54 AM


Document Has Been Signed on 04/03/2024 09:30 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754



FACILITY NAME:SHOKRY & IBRAHIM FAMILY CHILD CAREFACILITY NUMBER:
198020553
ADMINISTRATOR:M.SHOKRY & A.IBRAHIMFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 784-8421
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY:14CENSUS: 5DATE:
02/29/2024
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Mariam ShokryTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPAs) Cynthia Reyes and Saul Valenzuela conducted an unannounced annual inspection on this date. This inspection is to ensure the health and safety standards as required by the regulations governing child care homes are met. LPA met with Licensee Mariam Shokry. A copy of the Entrance Checklist for Child Care homes form (LIC 126) was provided. The facility operating hours are Monday through Friday 6 AM - 6 PM. A Covid risk assessment was conducted upon entry. Individuals residing in the home are 3 adults and 1 child.

Areas used by children are: The play room (next to kitchen), living room, dining room, bathroom #1 and back yard.

Areas off limits include: 3 bedrooms and 1 is the master bedroom with bathroom. Kitchen, front yard, garage, and 2 side yards of the home. **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.



Licensee does have the following posted: license, Parent’s Rights poster and other required forms posted. First Aid/CPR certificate are valid thru 10/15/2024 for licensee. Licensee does have mandated reporter certificate are valid thru 11/22/2024.

No cleaning supplies were observed. The home has electrical outlet covers throughout and maintains a First Aid Kit in the home. There are adequate age appropriate toys, books, and games. There are no firearm in the home. No *swimming pool, spa or body of water observed on the premises. The backyard is adequately fenced. Continue on next page

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:
DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/29/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SHOKRY & IBRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 198020553
VISIT DATE: 02/29/2024
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Licensing staff observed the following required posted documentation in the front entrance: Facility License, Publication (PUB) 394- Notification of Parent Rights and other Licensing Forms.

Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, and made inaccessible to children. The Isolation area for sick children waiting to be picked up is in the living room and other children will be away from the sick child in the day care room.

Licensee has 12 children enrolled. Roster was made available to licensing staff.

Licensee records were reviewed. LPAs did observed LIC 508- Criminal Record Statement. Licensee does have Proof of immunization's against measles and TDAP. Influenza declination is on file, TB clearance or risk assessment, and LIC 9108- Statement Acknowledging Requirement to Report Child Abuse were observed.

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/.

The following was observed and reviewed during this inspection. All areas identified on the facility sketch were inspected for safety, comfort, and cleanliness. There is telephone service via a land line and a cellphone that stays at the facility during operation hours. There is ventilation and heating. Detergents, cleaning compounds, and medications were observed to be inaccessible to children. The restroom that children use was observed to be safe and sanitary.
SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
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
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SHOKRY & IBRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 198020553
VISIT DATE: 02/29/2024
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LPA Reyes & Valenzuela observed the valve on the required 2A10BC fire extinguisher indicates fully charged, proof of purchase date was 03/07/2023. Fire extinguisher will expire one year after purchase date. Smoke detector and carbon monoxide was tested and is operable. Fire and earthquake drills conducted on 01/04/2024. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed on the parent board and were visible to parents and all to see.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.


LPAs did not observe any objects that can pose a danger to children in care.

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/process.

The department has On Duty Workers available for questions Monday through Friday at (323) 981-3350 from 8:00 AM - 5:00 PM.

LPA advised the licensee how to access forms and regulations on line at: www.ccld.ca.gov.

Criminal Record Clearance: 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.

Report continues on next page

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
L.A. DAY CARE-EAST, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: SHOKRY & IBRAHIM FAMILY CHILD CARE
FACILITY NUMBER: 198020553
VISIT DATE: 02/29/2024
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AB1207 Mandated Child Abuse Reporting – Implementation was discussed with Licensee. Website provided: http://mandatedreporterca.com.

Infant Care: 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-andresources/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. Per licensee no infants are in care at the moment.

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.



No deficiencies observed or cited on this date.

LPA provided consultation during this inspection. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Mariam Shokry, Licensee .

During the exit interview, Licensee Mariam Shokry, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

SUPERVISOR'S NAME: Christina GabelmanTELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia ReyesTELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:

DATE: 02/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/29/2024
LIC809 (FAS) - (06/04)
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