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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197401165
Report Date: 09/09/2022
Date Signed: 09/09/2022 01:33:37 PM

Document Has Been Signed on 09/09/2022 01:33 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:WASHINGTON FAMILY DAY CAREFACILITY NUMBER:
197401165
ADMINISTRATOR:ANN WASHINGTONFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 884-9497
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 10TOTAL ENROLLED CHILDREN: 7CENSUS: 1DATE:
09/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Ann Washington - LicenseeTIME COMPLETED:
01:50 PM
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Licensing Program Analyst (LPA) Alicia Bailey conducted an unannounced random annual (or Required) inspection. LPA met with Licensee Ann Washington and assistant at 09:45 am who guided the LPA on a tour of the facility. At 10:00 am during the inspection LPA Bailey discussed, assessed and noted individuals residing in the home. The facility Entrance Checklist for Family Child Care Homes was given to Licensee Washington. This large family child care home. This is a one story home consists of 2 bedrooms and 1 bathrooms, children room, detach garage, front yard and backyard. Areas used living room , one bedrooms one restrooms, front yard. Per Licensee Washington and facility sketch, areas off limits to children include: one bedroom, kitchen, back yard and garage .The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. The Licensee Washington stated no other license is held at the facility. There is 1 child present during time of inspection. Licensee Washington states that there is currently 7 children enrolled in the facility. Facility hours of operation Monday thru Friday 08:00am to 6:00 pm . The facility ages 0 months old to 12 years old.

At LPA Bailey ask licensee Washington do you have a firearm, licensee Washington state no. LPA Bailey ask licensee Washington do you own a pet licensee Washington state no.

At 10:45 am LPA Bailey observed , age appropriate toys and napping equipment. At 10:58 am LPA Bailey tour the children bathrooms. LPA Bailey did not observe any hazardous items in the bathroom.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE: DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/09/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON FAMILY DAY CARE
FACILITY NUMBER: 197401165
VISIT DATE: 09/09/2022
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At 11:08 am LPA Bailey toured the kitchen the counter tops were clean and free of clutter or standing food. Kitchen cabinets has safety lock and knives and medicine was in secure cabinet with safety lock. Licensee Washington provides breakfast, lunch and snack.

LPA Bailey observed there no swimming pool or body of water. At 11:20 am LPA Bailey observed first aid kit, fire extinguisher was last service on 03/23/2022. Licensee Washington state the last Earthquake & fire drill was conducted on 07/26/2022. First Aid supplies were inventoried. A review of medication policy, including administering, labeling, storage.

The smoke detectors, and carbon monoxide was tested by licensee is in operable condition.

At 11:30 AM LPA Bailey toured the front yard observed that all areas are adequately fenced and was inspected for hazard.

Licensee Washington mandated reporter training 04/28/2022. Licensee Washington PED F/A & CPR EXP. 04/19/24. Licensee Washington have record of immunization and TB clearance. Licensee Assistant mandated Reporter training 04/28/2022 Licensee Assistant PED F/A & CPR EXP. 05/20/2023



At 11:40 am LPA Bailey request the children files . LPA Bailey reviewed five children files five children files was in compliance.

Licensee Washington was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation. LPA Bailey reviewed with Licensee Washington different item prohibited in FCCH, no baby bouncers, no infant walkers, No Johnny jumpers, no saucer chairs, no trampolines and any other item that falls into that category are not permitted in the facility. Highchair are only use during feeding. Car seats are only use for transportation.

Licensee Washington provides transportation. At 11:56 am LPA Bailey also consulted with Licensee Washington regarding COVID-19 health and safety guidelines. At 12:10 PM LPA Bailey conducted staff interview with Licensee Washington.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON FAMILY DAY CARE
FACILITY NUMBER: 197401165
VISIT DATE: 09/09/2022
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Infant Needs and Services Plan: The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. Infant Care: LPA advised the applicant to sleep infants where they can be directly supervised at all time. LPA advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts was provided. LPA discussed PIN 20-24-CCP.

Overnight Care: There is no overnight care provided at the moment. LPA Bailey discussed the following: Licensee is aware that they must remain awake while children are awake. If children sleep in a separate area from the licensee, the door must remain open. If the licensee cannot hear children when they wake up, a video or audio device can be use.

LPA Bailey advise licensee Washington to review department website for current updates :

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.



To receive important licensed-related information to 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.

https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed [applicant, licensee, or facility representative] 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.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON FAMILY DAY CARE
FACILITY NUMBER: 197401165
VISIT DATE: 09/09/2022
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At 12:41 PM, the following was discussed with the Licensee Washington

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

The following was discussed with Licensee Washington Individuals who are 18 years of age or older living in the home must be fingerprint cleared prior to licensure. Individuals within one month of their 18th birthday must be fingerprinted immediately. The existing, immediate $100 per individual Civil Penalty has been increased to an immediate $100 per day Civil Penalty, for a maximum of five days for the first violation and a maximum of 30 days for subsequent violations. If an individual has a clearance with the Department a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

The licensee Washington is not providing Incidental Medial Services currently.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - 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

LPA Bailey reviewed Sudden Infant Death Syndrome (SIDS), Shaken Baby Syndrome, and safe sleep practices with licensee. *Infants should always sleep on their backs, mouths facing up.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
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, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WASHINGTON FAMILY DAY CARE
FACILITY NUMBER: 197401165
VISIT DATE: 09/09/2022
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LPA Bailey advise that Licensee Washington review the Department’s training videos
at https://ccld.childcarevideos.org/ in regards to (personal rights/supervision ect.).

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

****Licensee advised that signing the report does not imply agreement with the findings but is acknowledging receipt of the licensing report.*



An exit interview was conducted, and a copy of this report was provided to the Licensee Washington Notice of site visit was issued.
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022
LIC809 (FAS) - (06/04)
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