198400272-12-16-2020-54-CC-TTRN-BWCURR-20201216144527

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400272
Report Date: 12/16/2020
Date Signed: 12/16/2020 02:45:55 PM

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:	DOHERTY FAMILY CHILD CARE		FACILITY NUMBER:	198400272
ADMINISTRATOR:	ERENDIRA DOHERTY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 841-7732
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90808
CAPACITY:	14	CENSUS: 0	DATE:	12/16/2020
TYPE OF VISIT:	Prelicensing	UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Erendira Doherty, Licensee		TIME COMPLETED:	11:00 AM

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	This was a Prelicensing/Change of location inspection conducted by T. Tran, Licensing Program Analyst (LPA) due to COVID-19 and precautionary measures. This pre-inspection was conducted with Erendira Doherty, Licensee via a tele-inspection by use of Facetime. During inspection individuals who reside in the home were discussed and noted (see LIC 811). All adults that require a criminal record clearance are cleared. LPA advised licensee prior to any additional adults living or caring for children in the home, they must have a criminal record clearance. At this tele-inspection the Licensee took LPA on a tour of the home. About 9:40 A.M., the following was noted: Licensee is requesting a change of location from old facility located at 4634 Ostrom Ave CA, 90713 to the above location to serve 14 children. The Fire clearance was granted, and the control of property deed obtained. LPA observed current Pediatric CPR and First Aid Certifications (expire 05/20/2022). By the entrance, LPA observed a posting board posted Parents Rights and a current disaster plan. In addition, LPA observed the consolidated Covid-19 CHHS postings by the entrance, children's restroom and the daycare area. LPA discussed licensing requirements with licensee including the posting of licensing inspection notices and reports, as well as injury and incident reporting. This is a single home consists of 6 bedrooms, 4 1/2 bathrooms, a living room, a kitchen, a laundry room, and an attached garage. Per licensee, 3 bedrooms, a bedroom converted into an office room, a laundry room, and the kitchen area were off limit to daycare children. LPA observed the kitchen entrances has the safety baby gates to make the kitchen inaccessible to children in care. License acknowledged that children are never allowed in the off limit area. The primary daycare area are the two converted bedrooms by the hallway that were set up for childcare. Children have access to the living room and half the bathroom near the entrance of the house and another bathroom located in the daycare area. The home has central heating and air conditioning system. Living room observed to have an electrical fireplace with proper screened.

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2020

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 2

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: DOHERTY FAMILY CHILD CARE	FACILITY NUMBER: 198400272
	VISIT DATE: 12/16/2020

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

All cleaning chemical compounds observed to kept away from children's reach and locked. LPA discussed children's forms, records to be maintained at the facility. Per licensee, there is no pet in the home. LPA did not observe any pets during the tele-inspection. Licensee stated, there are no firearms in the home. The home did not observe to have any bodies of water. Licensee has the $300,000 liability insurance. LPA observed fire extinguisher rated 2A10BC located at the kitchen area and a working smoke detector/carbon monoxide mounted on the ceiling in the hallway. The backyard patio is completely fenced. LPA observed plenty of educational materials for children to utilize.

LPA provided the Licensing Agency website (www.ccld.ca.gov), licensee may obtain updated licensing information, regulations, and forms. LPA emailed to licensee PIN 20-15 Covid-19 update guidance for childcare setting, social distancing, Pin 20-24 safe sleep, and consolidated Covid-19 CHHS postings.

Effective today (12/16/2020) Facility is licensed to serve up to either 14 children - no more than 3 infants. 1 child in kindergarten or elementary school and 1 child at least age 6.

Exit interview was conducted with licensee, via tele-inspection, during which appeal rights were explained. 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 email, which will act as the licensee's signature

SUPERVISOR'S NAME: Trevino Cochran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR NAME: Tiffanie Tran	TELEPHONE: (323) 981-3350
LICENSING EVALUATOR SIGNATURE:	DATE: 12/16/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2020

LIC809 (FAS) - (06/04)

Page: 2 of 2