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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 334845493
Report Date: 06/28/2022
Date Signed: 06/28/2022 02:09:25 PM


Document Has Been Signed on 06/28/2022 02:09 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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501



FACILITY NAME:GREENWOOD FAMILY CHILD CAREFACILITY NUMBER:
334845493
ADMINISTRATOR:GREENWOOD, TIFFANYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 967-9571
CITY:WINCHESTERSTATE: CAZIP CODE:
92596
CAPACITY:14CENSUS: 4DATE:
06/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Licensee Tiffany GreenwoodTIME COMPLETED:
02:20 PM
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On 06/28/2022 at 10:15 AM Licensing Program Analyst (LPA) Susan Brewer, arrived at the facility to conduct an annual inspection. LPA was greeted and granted entry into the home by Licensee Tiffany Greenwood. LPA conducted a COVID-19 pre-screening and toured the facility, inside and out, reviewed records, and observed and/or discussed the following: Present were the licensee, 2 resident children, 1 staff and the licensee’s spouse
DAY & HOUR OF OPERATION: Regular August to June, Mon – Sat, 6:00 AM to 10:00 PM;
Temporary July Summer Hours Mon-Thu, 8:00 AM to 6:00 PM
OFF-LIMIT AREAS INCLUDE: 1st Floor Bedroom #1, Garage and Entire 2nd Floor

The inspection consisted of reviews of the following domain: Physical Plant, Care and Supervision, Records, Facility Administration, Staffing Ratio and Capacity, Personal Rights. The inspection found the facility to be in compliance in these domains, except as noted on the LIC809D. Deficiencies not cited this visit.

· The facility is operating within the licensed capacity and appropriate ratios. LPA took a census of 4 daycare children present and supervised on 06/28/2022.


· The Licensee is present in the home and has ensured that children in care are supervised.
· When temporarily absent from the home, the Licensee shall arrange for a substitute adult to care for and supervise children
· A working telephone is present.
· Appropriate fire extinguisher needle in the green, smoke detector working and carbon monoxide detector are present on 06/28/2022.
· All hazardous items are inaccessible, this includes detergents, cleaning compounds, medications and other items which could pose a danger to children.
· Storage of poisons is inaccessible to children and locked on 06/28/2022
· There is a properly barricaded fireplace on 06/28/2022.
SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2022
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 9


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GREENWOOD FAMILY CHILD CARE
FACILITY NUMBER: 334845493
VISIT DATE: 06/28/2022
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· Guns or weapons are present as stated by the Licensee Tiffany Greenwood on 06/28/2022. LPA S.Brewer verified the weapons to be locked and in compliance with Title 22 Regulations. Licensee understands all guns, weapons and ammunition must be key locked separately and made inaccessible per Title 22 regulations.
· Stairs are barricaded on 06/28/2022.
· Home is clean and orderly, with heating and ventilation for safety and comfort.
· Fire Clearance: 02/08/2021
· Safe and appropriate toys and equipment are present for both indoor and outdoor activities.
· Outdoor play areas are fenced and/ or appropriate supervision is present
· Verification of control of property by grant deed on 06/11/2018 verified.
· Pediatric CPR and First Aid Card expire on 02/2023
· Health & Safety Certificate - completed on 04/28/2019, Lead component on 02/17/2021.
· Mandated reporter General NOT ON FILE; AB1207 Child Care Expires: 02/2023
· Documentation of fire & earthquake drills to be conducted every six months: Last drill on 03/19/2021 @ 2:43 PM with 4 children present and went to the yard, not compliant.
· There are no bodies of water on 06/28/2022. Licensee Tiffany Greenwood understands all bodies of water including ponds, above ground pools & spas, in-ground pools & spas, and some fountains must be properly covered or fenced per Title 22 regulations. The Department must be notified before and after installation of the above types of bodies of water. In addition, all wading pools or similar product must be emptied immediately after use and stored in an upright position.
· Children’s files are NOT complete: LIC700 not on file for Child #1 and Child #2, information kept on Brightwheel application in computer, LIC9040 Facility Roster not on file, information kept in brightwheel. LPA requested print out of information that was not easily available for print or view. Infant Sleep Plan and Infant Sleep logs not on file for Child #3 and Child #4 and consultation provided.
· Staff files are NOT complete and still pending, however the licensee Tiffany Greenwood, is operating at a small capacity on 06/28/2022 due to lower enrollment.
licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Dept.

SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
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, 3737 MAIN STREET, STE 700
RIVERSIDE, CA 92501
FACILITY NAME: GREENWOOD FAMILY CHILD CARE
FACILITY NUMBER: 334845493
VISIT DATE: 06/28/2022
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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

Licensee Tiffany Greenwood, was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA Susan Brewer, discussed the safe sleep regulations with licensee Tiffany Greenwood 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.

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.

No citations issued on 06/28/2022.

No civil penalties issued on 06/18/2022.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted Tiffany Greenwood, the report reviewed and a copy left with the licensee.

SUPERVISOR'S NAME: Pauline BeschornerTELEPHONE: (951) 782-6641
LICENSING EVALUATOR NAME: Susan BrewerTELEPHONE: (951) 970-0343
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2022
LIC809 (FAS) - (06/04)
Page: 3 of 9