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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191593304
Report Date: 05/11/2022
Date Signed: 05/11/2022 03:32:30 PM

Document Has Been Signed on 05/11/2022 03:32 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:GAIL FAMILY DAY CAREFACILITY NUMBER:
191593304
ADMINISTRATOR:GAIL, JODY M.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(909) 816-9464
CITY:POMONASTATE: CAZIP CODE:
91767
CAPACITY: 14TOTAL ENROLLED CHILDREN: 4CENSUS: 1DATE:
05/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Licensee Jody GailTIME COMPLETED:
03:30 PM
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An unannounced, in-person, Annual-required inspection was conducted on this date by Licensing Program Analysts (LPAs) Emiko Bell and Nolan Tcheng.

When LPAs arrived at 12:15 pm, as no one answered the door, LPA Bell phoned and texted licensee. At 12:25, licensee opened the door and the reason for the inspection was announced.

As a precautionary measure against COVID-19, LPAs were face coverings the duration of the inspection and the COVID-19 screening questions were posed; Licensee responded "no" to all of the questions.

Census: There were no daycare children present upon LPA's arrival except for one minor who does not count in capacity due to they are over the age of 10. At 01:45 pm, an 11 year-old child arrived and at 01:57 pm, three more children arrived, ages 8 and 10.

Licensee's days and hours of operation are 24/7. This is a single-story, single family residence with four bedrooms and two bathrooms. All of the areas identified on the facility sketch were inspected in the following order: (outside) the backyard; and (inside): the dining room, the bedrooms, the bathroom used by the daycare children and the kitchen.

The areas which have been designated off-limits were not inspected: the bedrooms, one of the bathrooms, and the garage.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE: DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/11/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: GAIL FAMILY DAY CARE
FACILITY NUMBER: 191593304
VISIT DATE: 05/11/2022
NARRATIVE
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At 12:40 pm, Licensee began to guide LPAs on the tour of the residence. At 01:00 pm, LPAs observed licensee's fire extinguisher, which licensee stated she was not sure when it was purchased, but may have been a year and a half ago. Licensee also stated that she has not run a fire drill since she has children after re-opening in November 2020. Licensee has not had carbon monoxide detectors for about a month.

Physical Plant: The residence was inspected for safety, comfort, cleanliness, telephone service (licensee has a cell phone and a landline), heating and ventilation (licensee has central heating and air-conditioning in the daycare room as well as a door and a patio sliding door which can be opened for fresh air), inaccessibility to poisons, detergents, cleaning compounds and knives (there is a latch on the cabinet where the cleaning compounds are and the kinves are kept in a container on the top shelf of a kitchen cabinet), medicine (stored in the top cabinet above the oven) and other hazardous items that can pose a danger to children.

Toys and napping equipment: The licensee permits the children to sleep on her bed in her bedroom. In addition, licensee has several couches in the living room that the daycare children can sleep on.

Parent Board: Licensee's Parent Board is posted in the daycare room. All required postings were observed.

Pets: Licensee has one dog.

Fire safety: There is a smoke detector mounted in the hallway by the bedrooms and bathroom; it was tested and is operable.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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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: GAIL FAMILY DAY CARE
FACILITY NUMBER: 191593304
VISIT DATE: 05/11/2022
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Transportation: Licensee offers transportation.

Incidental Medical Services: Incidental Medical Services (IMS) policy was discussed. 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 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

There is one First Aid Kit, which is kept in the licensee's bedroom. The First Aid Kit was reviewed.

Backyard: The backyard is completely surrounded by a brick wall There is no pool or other body of water on the premises.

Paperwork: Licensee has a Child Care Facility Roster. Licensee's Pediatric First Aid/CPR was issued by the American Red Cross and expires 05/23. Licensee has not taken Mandated Reporter Training There are 4 children currently enrolled. Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights. The children's files were complete.

Based upon LPAs' observations and records review, four citations will be issued today.
SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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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: GAIL FAMILY DAY CARE
FACILITY NUMBER: 191593304
VISIT DATE: 05/11/2022
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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.

Licensee 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 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-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.

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

Exit interview conducted and report was reviewed with the Licensee Jody Gail.

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Betty Bell
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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Document Has Been Signed on 05/11/2022 03:32 PM - It Cannot Be Edited


Created By: Betty Bell On 05/11/2022 at 02:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GAIL FAMILY DAY CARE
FACILITY NUMBER: 191593304

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.543
Licensure Requirements
Every family day care home for children shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs' observation and licensee's own admission, the licensee did not comply with the section cited above in that licensee does not have any carbon monoxide detectors on the premises, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2022
Plan of Correction
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Licensee phoned Pomona Unified School District who stated that licensee can pick up a carbon monoxide detector from them; licensee stated she will pick it up on 05/12/22. Licensee will provide verification to the Department that she has obtained a carbon monoxide detector via text.
Type B
Section Cited
CCR
102417(g)(1)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs' observation and licensee's own admission, the licensee did not comply with the section cited above in that though licensee has a fire extinguisher, she is not sure when it was purchased or when it was last serviced. This poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2022
Plan of Correction
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Licensee stated she will purchase a fire extinguisher and provide verification to the Department via text that she has obtained a fire extinguisher.
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Betty Bell
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2022


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Document Has Been Signed on 05/11/2022 03:32 PM - It Cannot Be Edited


Created By: Betty Bell On 05/11/2022 at 02:38 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: GAIL FAMILY DAY CARE
FACILITY NUMBER: 191593304

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102417(g)(9)(A)
Operation of A Family Child Care Home
(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs' observation during record review and licensee's own admission, the licensee did not comply with the section cited above in that she has not run a fire drill since re-opening and resuming care of children in November 2020, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2022
Plan of Correction
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Licensee stated that she will run a fire drill and document the date and time it was ran. Verification will be provided to the Department upon completion.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on LPAs' observation during record review, the licensee did not comply with the section cited above in that if she completed Mandated Reporter Training, she could not provide verification of completion. This poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/23/2022
Plan of Correction
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Licensee stated that she will complete the Mandated Reporter Training and provide verification to the Department upon completion.
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:Claudia Guangorena
LICENSING EVALUATOR NAME:Betty Bell
LICENSING EVALUATOR SIGNATURE:
DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/11/2022


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