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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192004584
Report Date: 06/30/2022
Date Signed: 06/30/2022 02:20:08 PM

Document Has Been Signed on 06/30/2022 02:20 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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME:WEICKS FAMILY CHILD CAREFACILITY NUMBER:
192004584
ADMINISTRATOR:WEICKS, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 418-8382
CITY:LOS ANGELESSTATE: CAZIP CODE:
90047
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
06/30/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Kimberly WeicksTIME COMPLETED:
12:15 PM
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On June 30, 2022, Licensing Program Analyst (LPA), Veronica Wheatley conducted an announced Annual Required Inspection and met with the licensee Kimberly Weicks. There are no day care children present today. The hours of operation Monday through Friday, 6am and 6pm.

LPA toured the home inside and out and took a census was taken of no day care children. Current facility sketch reviewed and confirmed that the living room/day care room is used for providing care and is accessible to children. All other 3 bedrooms are off-limits and made inaccessible. There is no swimming pool or other bodies of water on the premises. Per licensee, there are no firearms or ammunition on the premises. Detergents, cleaning compounds, medication and other hazardous items are made inaccessible with child proof locks in the kitchen and main bathroom. There is a working fire extinguisher, smoke detector, carbon monoxide and adequate ventilation for safety and comfort. According the licensee, there is central heating and air condition. Safe toys and play equipment are observed. The home has a working telephone.

LPA discussed Safe Sleep Regulations with licensee. Cribs and play yards will be kept free from all loose articles and objects while infants are sleeping, and there are no objects hanging above or attached to the crib or play yard. Infants are not swaddled while in care. Provider will physically check on sleeping infants every fifteen minutes and document any signs of distress which includes but is not limited to flushed skin color, increase in body temperature, restlessness and labored breathing. Infants can be visually observed through an open door if sleeping in a separate room. Individual Infant Sleeping Plan is completed and in file for each infant up to 12 months of age. Infants up to 12 months of age are placed on their backs for sleeping.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/30/2022
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: WEICKS FAMILY CHILD CARE
FACILITY NUMBER: 192004584
VISIT DATE: 06/30/2022
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Licensee ensures that children in care are supervised at all times and is aware children shall not be left in parked vehicles. Car seats are used for transportation purposes only and are not used for sleeping children. Licensee states she transports children. LPA informed licensee that written approval from the parents or authorized representative in order to transport children. Capacity as specified on the license is being maintained. The outdoor play area in the backyard is fenced. The yard is clean and safe. LPA observed age appropriate toys and equipment. There are no pets and no bodies of water. The garage is off-limits.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was completed on 1/19/22. Licensee’s pediatric CPR/First Aid expires on 6/23/24. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles.

All adults who reside or work in the home have a criminal record clearance or exemption. There are no excluded individuals present at this home. Incidental Medical Services (IMS) are not currently being provided. Licensee is aware that an IMS plan is required to be submitted to the licensing office if they provide any of these services. Information regarding Americans with Disability Act (ADA) can be obtained by contacting US Department of Justice toll free ADA Information line at (800) 514-0301(voice), (800) 514-0383 (TDD) and website link https://www.ada.gov/childqanda.htm.

LPA discussed with the licensee the Community Care Licensing website www.ccld.ca.gov. Licensee states she is receiving the Provider Information Notices (PINs), Quarterly Updates, COVID-19 Information and Resources, Mandated Reporter Training, Safe Sleep in Child Care, Lead Poisoning Facts, Forms and Regulations.

Per Title 22, Division 12, Chapter 3, of the California Code of Regulations, no deficiencies are cited.

Exit interview. A copy of this report was provided to the licensee today.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 06/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2022
LIC809 (FAS) - (06/04)
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