<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198400181
Report Date: 05/13/2022
Date Signed: 05/13/2022 04:48:09 PM


Document Has Been Signed on 05/13/2022 04:48 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:PATRICK FAMILY CHILD CAREFACILITY NUMBER:
198400181
ADMINISTRATOR:JENNIPHER PATRICKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 354-8735
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY:14CENSUS: 5DATE:
05/13/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:14 PM
MET WITH:Jennipher Patrick - Licensee TIME COMPLETED:
04:47 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) Alicia Bailey conducted an unannounced random annual (or Required) inspection. LPA met with Licensee Patrick at 1:14 pm, who guided this LPA on a tour of the facility. At 1:18 pm during the inspection, LPA Bailey discussed, assessed, and noted individuals residing in the home. The facility Entrance Checklist for Family Child Care Homes was given to Licensee Patrick. This is a one story home consisting of 3 bedrooms and 2 bathrooms. Areas used by the children include the day-care room, one ( bedrooms), one (1) restroom, and the backyard. Per Licensee Patrick and facility sketch, areas off-limits to children include 2 ( two) bedrooms, one bathroom, kitchen, and the garage. The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. A parent board with required postings was observed at the entrance of the facility. The Licensee Patrick stated there is no other license held at this facility. There were five children and a Licensee assistant during the time of inspection. Licensee Patrick states that there are currently ten children enrolled. Facility hours of operation are Sunday thru Saturday from 6:00 am to 4:59 am 23 hours.

There are NO weapons or firearms in the facility. LPA Bailey observed there was no swimming pool or body of water. At 1:28 pm, LPA Bailey observed a first aid kit and fire extinguisher 2A10BC) in the day-care room. LPA Bailey ask Licensee Patrick when was the last time you had the fire extinguisher services , Licensee Patrick state she just purchase the fire extinguisher. LPA Bailey advise Licensee Patrick that she need to see a copy of the receipt. Licensee Patrick state she understood. The smoke detectors and carbon monoxide were tested by LPA and are in operable condition.

SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/13/2022
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 6


Document Has Been Signed on 05/13/2022 04:48 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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/13/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above in [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/13/2022
Plan of Correction
1
2
3
4
Licensee Patrick state will correct by POC date
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4

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: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:
DATE: 05/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/13/2022
LIC809 (FAS) - (06/04)
Page: 2 of 6


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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 05/13/2022
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
26
27
28
29
30
31
32
At 1:45 pm LPA Bailey observed a large television mounted to the wall, in the day care you, LPA Bailey also observed age-appropriate toys, and napping equipment in the day care room and 1 bedroom. At 1:58 pm, LPA Bailey toured the children's bathroom. LPA Bailey observed children's safety latches on the bathroom cabinet. LPA Bailey did not observe any hazardous items in the bathroom.

At 2:10pm LPA Bailey toured the kitchen ( off-limit). The countertops were clean and free of clutter or standing food. The kitchen cabinets have a safety lock and knives and the medicine was in a secure cabinet with a safety lock. Licensee Patrick provides breakfast, lunch, and snacks.

At 2:20 pm, LPA Bailey toured the backyard and observed that all areas were adequately fenced and were inspected for hazards. LPA Bailey observed age appropriate toys in the backyard. At 2:41pm, LPA Bailey, reviewed the Disaster Plan; the Emergency Disaster Drill was reviewed. LPA Bailey observed Licensee Patrick conducting fire & earthquake drills on 04/21/2022. A current Children's roster was viewed and maintained for a period of 3 years, even after children are no longer attending the facility.

Licensee has mandated reporter training expired. LPA Bailey advised licensee Patrick that mandated reporter training expire after two years and that she and her staff would need to update training certificate. Licensee Patrick state she understood and will take the training by the POC date. Licensee & Licensee Assistants PED F/A & CPR expired. LPA Bailey advised Licensee Patrick of the expired CPR & first aid card. Licensee Patrick state that she recently took the class and is waiting on her card. LPA Bailey advise Licensee Patrick to have it by the POC date.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC809 (FAS) - (06/04)
Page: 3 of 6
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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 05/13/2022
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
26
27
28
29
30
31
32
At 2:55 pm, LPA Bailey reviewed ten children's facility files. Out of ten children's facility files five was in compliance and five was not incompliance. LPA Bailey advised licensee Patrick of the missing document or signature missing she state she understood and will have children facility in compliance by POC date.

At 3:10 pm, LPA Bailey reviewed three personal files, LPA Bailey observed that three personal files was not incompliance. LPA Bailey advise licensee Patrick of the missing documents licensee Patrick state she understood.

Licensee Patrick was advised that regulations prohibit the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation. LPA Bailey reviewed with Licensee Patrick different items prohibited in FCCH, no baby bouncers, no infant walkers, no Johnny jumpers, no saucer chairs, no trampolines, and any other items that fall into that category are not permitted in the facility.

At 3:20 pm, Licensee Patrick was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation. Licensee Patrick provides transportation for school-age children.

At 3:28 pm, LPA Bailey also consulted with Licensee Patrick regarding COVID-19 health and safety guidelines. LPA Bailey observed COVID- 19 postings posted in different areas of the day care for parents, as well as for children at eye level in their day care room.

At 3:33 pm, LPA Bailey conducted a staff interview with Licensee Patrick.
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 05/13/2022
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
26
27
28
29
30
31
32
At 3:50 pm, the following was discussed with the Licensee,

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

LPA Bailey reviewed Sudden Infant Death Syndrome (SIDS), Shaken Baby Syndrome, and safe sleep practices with licensee. *Infants should always sleep on their backs, mouths facing up.

Infant Needs and Services Plan: The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. Infant Care: LPA advised the applicant to sleep infants where they can be directly supervised at all times. LPA advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided. LPA discussed PIN 20-24-CCP.

The licensee Patrick is not providing Incidental Medial Services currently.

The incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - 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
SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: PATRICK FAMILY CHILD CARE
FACILITY NUMBER: 198400181
VISIT DATE: 05/13/2022
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
26
27
28
29
30
31
32
The following was discussed with Licensee Patrick Individuals who are 18 years of age or older living in the home must be fingerprint cleared prior to licensure. Individuals within one month of their 18th birthday must be fingerprinted immediately. The existing, immediate $100 per individual Civil Penalty has been increased to an immediate $100 per day Civil Penalty, for a maximum of five days for the first violation and a maximum of 30 days for subsequent violations. If an individual has a clearance with the Department, a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

The following ( 809 D page) deficiencies were observed by Title 22 of the California Code of Regulations. The consultation was conducted on this date.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

An exit interview was conducted, and a copy of this report and appeal rights was provided to the Licensee Patrick. Notice of site visit was issued.


SUPERVISOR'S NAME: Karen ChambersTELEPHONE: (323) 980-4934
LICENSING EVALUATOR NAME: Alicia BaileyTELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:

DATE: 05/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2022
LIC809 (FAS) - (06/04)
Page: 6 of 6