<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197402163
Report Date: 03/30/2023
Date Signed: 03/30/2023 11:28:06 AM

Document Has Been Signed on 03/30/2023 11:28 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:EVANS FAMILY CHILD CAREFACILITY NUMBER:
197402163
ADMINISTRATOR:EVANS, DONNAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 631-5556
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 12TOTAL ENROLLED CHILDREN: 11CENSUS: 11DATE:
03/30/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Co-Licensee - Mshairi EvansTIME COMPLETED:
11:50 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) R. Derraco conducted a required 1 year inspection to the above facility on 03/30/23. LPA arrived at the facility at 9:15 AM and met with co-licensee, Mshairi Evans, who guided analyst on a tour of the facility. Also present during this inspection was co-licensee Donna Evans. Per Licensee, there are 11 children that are currently enrolled. There were 11 children present upon arrival.

This is a one-story home which consists of 4 bedrooms, 3 bathrooms, kitchen, dining room, living room, laundry area, den, garage, front yard and backyard (fenced). The off limit areas include 2 bedrooms, 2 bathrooms, dining room, living room, kitchen, garage, and front yard.

The main care area is located in the Den. LPA observed children's reading materials, school age desks and chairs, art materials, and educational posters. Bedroom 1 was observed with age appropriate toys, sensory play equipment, and school age desks and chairs. Bedroom 2 was observed with additional school age desks and chairs, bedroom furniture and a bed. The bathroom was observed to have an operable sink, toilet, and faucet. LPA observed cleaning supplies kept in a cabinet located in the bathroom. Child locks were observed on the cabinet making the contents inaccessible. The backyard was observed to have additional age appropriate toys, child sized climbing structures, and outdoor play equipment. Perimeter fencing was observed throughout the backyard play area. The licensee states that she provides food for children in care. Per licensee, isolation area for children showing signs of illness will be located in a bedroom while they await parent pick up. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted in the main care area. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. Per licensee, they own two dogs that stay behind a fence in the off-limits area of the backyard.

(page 1 of 3)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE: DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/30/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: EVANS FAMILY CHILD CARE
FACILITY NUMBER: 197402163
VISIT DATE: 03/30/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Individuals who reside in the home were noted and discussed. 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.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a land line. Detergents, cleaning compounds, and other items which could pose a danger to children were observed to be locked above the refrigerator and the stove in the off-limits kitchen. The licensee understands that storage areas for poisons must be locked, not just inaccessible. Per Licensee, the home is equipped with a heating and air conditioning unit mounted in the main care area. LPA observed the unit to be mounted on the wall towards the ceiling making it inaccessible to children in care. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home. The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 03/25/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable.

The licensees have completed training on preventive health practices including Pediatric First Aid and CPR. The licensees Pediatric First Aid and CPR expires on 06/25/23. LPA observed that the Licensees has proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. Children’s records were reviewed, including emergency information and were observed to be complete. A current children’s roster was available for review.

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.
(page 2 of 3)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC809 (FAS) - (06/04)
Page: 4 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: EVANS FAMILY CHILD CARE
FACILITY NUMBER: 197402163
VISIT DATE: 03/30/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Mshairi Evans


(page 3 of 3)
SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:

DATE: 03/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/30/2023
LIC809 (FAS) - (06/04)
Page: 5 of 5