198020670-3-8-2021-33-CC-CRES-BYWNQ2-20210308093913

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198020670
Report Date: 03/05/2021
Date Signed: 03/08/2021 09:39:55 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	TARPLEY-PELHAM & WALKER FAMILY CHILD CARE		FACILITY NUMBER:	198020670
ADMINISTRATOR:	M.TARPLEY-PELHAM &A.WLAKER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(626) 359-9943
CITY:	AZUSA	STATE: CA	ZIP CODE:	91702
CAPACITY:	14	CENSUS: 0	DATE:	03/05/2021
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	03:00 PM
MET WITH:	Mary Tarpley-Pelham		TIME COMPLETED:	05:10 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	Change of location Inspection Conducted In English Licensing Program Analysts (LPA) Cynthia Reyes conducted an announced change of location inspection on this date. Due to COVID-19 all precautionary measures were taken by the LPA and the applicant during this inspection. Applicant confirmed family members residing in the home, that consists of 4 adult and 0 children. Per Mary, operating hours will be Monday to Sunday, 6:00 AM to 6:00 PM. Applicant was previously licensed for a large capacity under F# 198013159. LPA and Applicant began the home tour at the front door where she states during Covid-19, no parents are allowed inside the home and children health checks which include temperature being taken will be conducted prior to children entering the home at the front door. During this tour, the following was noted: At 3:12 PM the inspection began at the front yard which the applicant states is off limits to the children. Applicant proceeded to take the LPA inside the front door and straight a head to a room that she designated as her office and the ill isolation area for a sick child. A short hallway is next to the room which has two bedrooms and a bathroom that are off limits and the hallway is blocked by a plastic baby gate. Next is the living room that is accessible to the children and has a wall heater that is covered and turned off by the gas company. Applicant showed LPA a portable heater she will use for the children if it is cold. Next to the living room is the kitchen area that is off limits to the children and blocked by a plastic baby gate. Applicant showed LPA latches on the lower kitchen cabinets that have hazardous cleaning items. Knives and medicines are in a box on a high cabinet in the kitchen. 3:35 PM Applicant continued the tour to another small hallway that had the parent board with all the posting observed by the LPA and to the left was the main class room used for the day care. LPA observed age appropriate toys and furniture. In the same hallway is the bathroom used by the children with no hazardous items accessible. Next to the rest room is another bedroom off limits to the children. The tour continued at 3:50PM to the back yard that is accessible to the children. LPA observed a large circle hanging swing that looks like a trampoline. LPA took photos and asked applicant to submit documentation of this items for consultation with the LPM.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: TARPLEY-PELHAM & WALKER FAMILY CHILD CARE	FACILITY NUMBER: 198020670
	VISIT DATE: 03/05/2021

NARRATIVE

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Page 2 Continued.
Walk threw continued around the back yard and LPA observed a shed that is in need of a lock. There is grass around the yard for cushion material and age appropriate toys. LPA and applicant went back in the home where the 2A10BC fire extinguisher was observed hanging between the kitchen and class room with a receipt attached to it with the purchase date of 01/12/2021. Applicant at 4:15 PM tested the smoke detector and carbon monoxide that were observed by the LPA to be in operating condition. LPA observed Covid-19 signs posted at eye level for the children around the home.

At 4:25 PM LPA went over the areas observed by the LPA & confirmed by the licensee during the inspection, that are: Off limits areas that include: Master Bedroom with bath, 2 other bedrooms, Kitchen, front yard and the Garage. **Rooms that are off-limits need to be made inaccessible during operating hours** The applicant does understand that licensing staff may have access to off-limit areas during the inspection if necessary.

The areas used by children include: Living room, office (isolation area), bathroom, classroom, and back yard.

4:30PM LPA Discussed with the applicant. Infant Care: LPA advised the applicant to sleep infants where they can always be directly supervised and advised against sleeping infants in a separate room. LPA advised of the Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. A online copy can be downloaded at: https://www.cdph.ca.gov/programs/SIDS/Documents/SIDSchildcaresafesleep.pdf

Incidental Medical Services (IMS) policy. 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 and the ADA, available at: http://www.ada.gov/childqanda.htm

The licensee Pediatric First Aid and CPR. (Exp. 03/02/2023). Applicant Mary just took on 03/02/2021. LPA did observe co-applicant Amina Walker has a current Pediatric First Aid and CPR that Exp. 08/01/2022. LPA observed there is appropriate first aid supplies available on the premises.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2021

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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: TARPLEY-PELHAM & WALKER FAMILY CHILD CARE	FACILITY NUMBER: 198020670
	VISIT DATE: 03/05/2021

NARRATIVE

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· Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.

· In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunization's (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.

· Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.

· The fire extinguisher type 2A-10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.

· Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.

· Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.

· Fire and safety drills must be performed each month and documented for review by the Department.

· Smoking is prohibited in a family childcare homes.

· Children and Staff records must be maintained and updated as needed and must be available for review by the Department. If Children and Staff leave the day care all records must be maintained for 3 years after leaving.

· Inspection Authority: All adults living and working in the home shall be made aware of the Department’s right to inspection of the home, which includes, but is not limited to the right to enter the home when children are being cared for, interview children and adults, review documentation and observe off limit areas if needed.

· The facility license number must be on all advertisements, publications or announcements with the intent to attract clients.

- Isolation for Ill children: When a child is ill he/she shall be separated from other children (reference 102417(e) Operation of a Family Child Care Home).

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2021

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
CCLD Regional Office, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: TARPLEY-PELHAM & WALKER FAMILY CHILD CARE	FACILITY NUMBER: 198020670
	VISIT DATE: 03/05/2021

NARRATIVE

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Page 4 Continued
· Liability Insurance was discussed; LPA advised applicant to review Title 22 Regulation 102417(m)(1) for additional information.

· Immunization Requirement: 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. The licensee and all adults working with children have proof of immunization's.

· Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com Amina took on 04/21/2019 & Mary on 04/21/2019

4:45 PM LPA advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov. LPA consulted with applicant regarding COVID-19 health and safety guidelines on this date, applicant was provided forms to post via email. Licensing staff observed COVID- 19 postings posted in the day care on this date. During this inspection LPA discussed PIN 20-06 CCP, Social and Physical Distancing Guidance And Healthy Practices For Child Care Facilities In Response To The Global Corona virus (COVID-19) Pandemic Written In Collaboration With The California Department Of Education. LPA reviewed with the applicant the Child Care Covid-19 Self-Assessment guide the applicant filled out and sent in on 02/03/2021 before this inspection.

Applicant’s email address is on file. The applicant was advised that the email may be public information.

There is an approved (02/03/2021) fire clearance on file.

Based on LPA observations, the following corrections need to be corrected prior to obtaining a Large family childcare license. Latch on back yard shed and final file review.

The application will be submitted for license after completions of correction. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license. At that time, the licensee home will meet the description of a safe and healthy environment for children as described in Chapter 1, Division 12, Title 22 of the California Code of Regulations, and will be submitted for approval to be licensed as a Large (14) Family Child Care Home. 5 PM The exit interview was conducted with Mary Tarpley-Pelham. This report along with a copy of the appeal rights will be sent to the Licensee via email with a read receipt or confirmation of receipt of the email, which will act as the Licensee’s signature.

SUPERVISOR'S NAME: Christina Gabelman	TELEPHONE: (323) 981-3380
LICENSING EVALUATOR NAME: Cynthia Reyes	TELEPHONE: (323) 981-3369
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2021

LIC809 (FAS) - (06/04)

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