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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 191811236
Report Date: 08/11/2023
Date Signed: 08/11/2023 01:36:24 PM

Document Has Been Signed on 08/11/2023 01:36 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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:MABRY FAMILY DAY CAREFACILITY NUMBER:
191811236
ADMINISTRATOR:MABRY, LINDA R.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(213) 215-1567
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
08/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:13 AM
MET WITH:Linda Mabry, LicenseeTIME COMPLETED:
01:51 PM
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On 08/11/2023 at 9:13am, Licensing Program Analyst (LPA) Laticia Thompson, conducted an unannounced annual inspection. LPA met with Linda Mabry, Licensee, who assisted LPA with touring the facility.

This a one story home that consists of 5 bedrooms and 2 bathrooms. The licensee provides care for children ages, birth to 17 years. The operating hours are Sunday- Saturday 6:00 AM - 5:59 AM.

All areas identified on the facility sketch were toured both indoors and outdoors. Licensee provided an updated facility sketch. Care will be provided in Living/Dinning Room(Play Area) and Family Room. Children will use both bathrooms in the home. Licensee will not use front yard and back yard while caring for children. Licensee will conduct outdoor play at the local park that is within walking distance.

Furniture and equipment were inspected for age appropriateness and good repair. Telephone service, heating, lighting and ventilation were evaluated. Licensee has one napping cot. Licensee will purchase additional cots pending children enrollment. Licensee stated she has one baby crib in storage readily available pending infant enrollment. Per Licensee the family room will be used as a isolation area and child care children will relocate to the play area located in the living room and dinning room. LPA observed that facility does have a carbon monoxide detector and smoke alarm combination located in the hall next to the front bathroom. Licensee has a 3-A:40-B:C fire extinguisher tagged with a last inspection date of September 6, 2001.
--Page 1 of 4

SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE: DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/21/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MABRY FAMILY DAY CARE
FACILITY NUMBER: 191811236
VISIT DATE: 08/11/2023
NARRATIVE
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Disinfectants, cleaning solutions, medication and other items that are dangerous to children, will be inaccessible to children. Licensee states that there are no poisons are firearms in the home.

The Licensee will provide breakfast, lunch, am and pm snack. Dinner will be provided to children during evening care.

All kitchen areas/food preparation areas and food storage areas were observed to be clean and are free of litter, rubbish, rodents, and/or any other vermin. All storage containers for solid waste, including moveable bins shall have tight-fitting covers that are kept on, and in good repair. Trash cans used to discard food will be replace with a tight fitting lid. The facility was observed to be free of flies, other insects and rodents.

There are no bodies of water on the premises.



Applicants state that medication will be stored in bedroom #2 in an off limits area. Licensee has 2 first aid kits and were observed to contain the required first-aid supplies.

Fire drill and disaster log is located on the wall next to the front door. Licensee has the required posted documents in an area that parents may observe. There are no stairs inside the home. The wall heater has a protective screen. Licensee has a mandated reporter certificate dated 7/22/2023.

There were no records of children to review at this time. Licensee has been in inactive status. Licensee stated last date of enrollment of children was in the year of 2001. Licensee does not have any staff files to review.

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SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MABRY FAMILY DAY CARE
FACILITY NUMBER: 191811236
VISIT DATE: 08/11/2023
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The following items are to be corrected and in compliance with Title 22, California Code of Regulations

The fire extinguisher last inspection was conducted in 8/06/2001. Fire extinguisher must be inspected by the fire department or replaced.



Licensee has a first aid certificate dated 07/05/2023 that does not reflect children and pediatric. Licensee does not have training in preventive health practices

Licensee does not have immunization documentation.

The above of correction are will be completed by 08/21/2023

Items discussed during this visit:

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.


--Page 3 of 4
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
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
EL SEGUNDO CC NORTH, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MABRY FAMILY DAY CARE
FACILITY NUMBER: 191811236
VISIT DATE: 08/11/2023
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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

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.



During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

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

Exit interview conducted and report was reviewed with the licensee, Linda Mabry.

--Page 4 of 4
SUPERVISORS NAME: Rita Ramos
LICENSING EVALUATOR NAME: Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/11/2023 01:36 PM - It Cannot Be Edited


Created By: Laticia S Thompson On 08/11/2023 at 12:51 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
, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME: MABRY FAMILY DAY CARE
FACILITY NUMBER: 191811236

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/11/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.622(a)(1)
General Provisions and Definitions
(1) 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. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 08/21/2023
Plan of Correction
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Licensee will provided the deparment with proof of immunizations DTAP and MMR
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Rita Ramos
LICENSING EVALUATOR NAME:Laticia S Thompson
LICENSING EVALUATOR SIGNATURE:
DATE: 08/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/11/2023


LIC809 (FAS) - (06/04)
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