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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 192006738
Report Date: 05/04/2023
Date Signed: 05/04/2023 07:34:35 PM

Document Has Been Signed on 05/04/2023 07:34 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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:LAVELLE FAMILY CHILD CAREFACILITY NUMBER:
192006738
ADMINISTRATOR:LAVELLE, L & KELLY, S.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 930-5769
CITY:COMPTONSTATE: CAZIP CODE:
90222
CAPACITY: 14TOTAL ENROLLED CHILDREN: 20CENSUS: 9DATE:
05/04/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Lorna Lavelle, LicenseeTIME COMPLETED:
05:45 PM
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Licensing Prrogram Analyst (LPA) Alicia Mooberry conducted an Unannounced Annual Inspection on this date. LPA arrive to the facility at 1:20pm and met with Lorna Lavelle, Licensee, LPA explained the purpose of inspection and provided the inspection Entrance Checklist, LIC 126. Upon arrival LPA observed a flooring contractor working in the home. In the bedroom used by children in care, LPA observed a drill, paint and materials accessible to children in care (photo taken), LPA also observed outlet wall plates and switch covers were missing (photo taken) this poses and immediate risk to the health and safety of children in care. The children present were removed to outdoor and the contractor removed the hazardous items. Per licensee, the children are using the bathroom in the hallway.

LPA inspected rooms/areas on the facility sketch in which child-care services are provided and to which children have access, as well as off limit areas. Per licensee the hours of operation are Monday-Friday 6:00am - 6:00pm. Licensee also provided overnight care Monday - Sunday 6pm-6:00am. Care provided during the day and overnight combined shall not exceed 24 hours from the time the child entered into care. LPA discussed Overnight Care requirements with licensee. There were nine (9) children present. Also present were Shannell Kelly (Co-Licensee), and Latasha Myles, Assistant. All adults present have been cleared and associated. Individuals residing in the home were discussed and noted.

This is a single story home which consists of four (4) bedrooms, two (2) bathrooms, kitchen, living/dining (used as main day area), kitchen with laundry area, detached garage, front and back yard.

Per licensee, the areas used by children include: living/dining (used as main day area), bathroom (in hallway), kitchen, front yard


Off limit areas are: Three (3) Bedrooms, detached garage, back yard. Temporarily off limits is the bathroom located in bedroom used by children in care. The bathroom was closed and locked during inspection and will remain closed until the flooring is completed.

Page 1 – Report Continues

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE: DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/04/2023
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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738
VISIT DATE: 05/04/2023
NARRATIVE
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Areas that are used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. Rooms that are off-limits need to be made inaccessible during operating hours. The licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.

LPA advised licensee to post the facility license, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form in area visible to parent/guardians of children in care. Licensee was advised to place the facility license number on all forms of advertising to the public including banner in front of home, flyers, business cards, online advertisement. LPA observed completed LIC 610- Facility Disaster Plan.

Smoke and carbon monoxide detectors were tested and are operable. Fire extinguisher indicated fully charged with purchase receipt dated 2/16/2020, Licensee was reminded that fire extinguisher needs to be serviced yearly. The home maintains telephone service. There are toys and other age appropriate material available for children. LPA observed that cleaning compounds are in laundry area in locked overhead cabinet inaccessible to children.

LPA observed pesticides and other chemicals stored in locked detached garage in back yard. Per Licensee there are no firearms or weapons stored in the home.


Isolation area for sick children waiting to be picked up is in living room, away from the other children.

Per licensee, there are no infants (children under 24 months of age) enrolled or attending the daycare. 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.

Children use the front yard for outdoor play. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has age appropriate toys and other materials for children to play with artificial grass. LPA did not observe any objects that could be hazardous to children in care. Facility does not have a pool or similar bodies of water.


-------------------Page 2 – Report Continues
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
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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 CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738
VISIT DATE: 05/04/2023
NARRATIVE
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Staff and Children’s records were unavailable to be reviewed on this date.
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

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.

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/inspection-process.

Based on the LPA's observations and records review the following deficiencies will be cited today in accordance with California Title 22 Regulations.

A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement form must be maintained in each child’s file immediately upon receipt from parent. A copy of the Parent Notification Requirements was also provided to the licensee.

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

Exit interview conducted and report was reviewed with the Licensee, Lorna Lavelle. Appeal Rights were discussed and a copy provided.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2023
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Document Has Been Signed on 05/04/2023 07:34 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 05/04/2023 at 04:17 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416(c)
Personnel Requirements
(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above in 2 out of 3 adults present supervising children have proof of Pediatric CPR/1st Aid training which posesa potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/25/2023
Plan of Correction
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Proof of correction will be submitted to the department by email by POC due date
Type B
Section Cited
CCR
102416.1(d)
Personnel Records
(d) All personnel records shall be maintained at the child care home and shall be available to the licensing agency for review.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above in that licensee confirmed 3 out of 3 adults present supervising children do not have facility files which posesa potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/25/2023
Plan of Correction
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Proof of correction will be submitted to the department by email by POC due date
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/04/2023


LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 05/04/2023 07:34 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 05/04/2023 at 04:17 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
102417(g)
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:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above in that there were power tools, paint, missing outlet wall plates and missing switch cover in bedroom that children use which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 05/05/2023
Plan of Correction
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Licensee removed the power tools and made the room inaccessible to children in care. The outlet and light swith will be covered. Proof of corrections will be sent to LPA by POC due date (within 24 hours).
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/04/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/04/2023 07:34 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 05/04/2023 at 04:17 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102416.3(a)
Alterations to Existing Building or Grounds
(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following:

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above due to a flooring contractor was present during daycare hours making alterations to the bathroom located in bedroom used by children in care, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/11/2023
Plan of Correction
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Licensee will complete and provide to the depatment a completed LIC 624B reporting the alterations to the home and sent to LPA via email by POC due date
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 interview, the licensee did not comply with the section cited above, licensee confirmed that the immunization records for 3 out of 3 adults providing supervision to children in care are not available which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/25/2023
Plan of Correction
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Proof of correction will be sent to LPA vial email by POC due date.
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/04/2023


LIC809 (FAS) - (06/04)
Page: 6 of 7
Document Has Been Signed on 05/04/2023 07:34 PM - It Cannot Be Edited


Created By: Alicia Mooberry On 05/04/2023 at 04:17 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LAVELLE FAMILY CHILD CARE
FACILITY NUMBER: 192006738

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/04/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
102418(a)
Immunizations
(a) Prior to admission to a family day care home, children shall be immunized against diseases as required by the California Code of Regulations, Title 17, beginning with Section 6000.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview, the licensee did not comply with the section cited above in 9 out of 9 children in care did not have faciliy files including proof of immuniczations, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/25/2023
Plan of Correction
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2
3
4
Proof of correction will be sent to LPA via email by POC due date.
Type B
Section Cited
CCR
102417(g)(8)
Operation of A Family Child Care Home
(8) Each family child care home shall have a current roster of children as specified in Health and Safety Code Section 1596.841.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on licensee confirmation the licensee did not comply with the section cited above in that the children's roster was not available which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/05/2023
Plan of Correction
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2
3
4
Proof of correction will be sent to LPA via email by POC due date (5/5/23)
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:Valarie Cook
LICENSING EVALUATOR NAME:Alicia Mooberry
LICENSING EVALUATOR SIGNATURE:
DATE: 05/04/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/04/2023


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