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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405743
Report Date: 02/18/2022
Date Signed: 02/18/2022 01:03:52 PM

Document Has Been Signed on 02/18/2022 01:03 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:PERGES AND LEAVELL FAMILY CHILD CAREFACILITY NUMBER:
197405743
ADMINISTRATOR:PERGES, S. AND C. LEAVELLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 918-3725
CITY:COMPTONSTATE: CAZIP CODE:
90220
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
02/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Shenae Perges - Licensee TIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA) Alicia Bailey conducted an unannounced random annual (or Required) inspection. LPA met with Licensee Perges at 10:15 am who guided this LPA on a tour of the facility. At 10:17am 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 Perges. This is a one-story home consists of 4 bedrooms and 3 bathroom. Areas used by the children include the day-care room, one (1) restroom, 1 bedroom and back yard. Per Licensee and facility sketch , areas off limits to children include: 3 ( three) bedrooms .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. A parent board with required postings was observed at the entrance of the facility. The Licensee stated there are no other license held at this facility. There were no children during time inspection. Licensee states that there are currently two children enrolled. Facility hours of operation Monday thru Friday 7:00am to 7:00pm

There are NO weapons, firearms in the facility. LPA Bailey observed there no swimming pool or body of water. At 10:50 am LPA Bailey observed first aid kit, fire extinguisher 2A10BC ( service 06/22/2021) in the day care room. The smoke detectors, carbon monoxide was tested by LPA are in operable condition.

At 10:55am LPA Bailey tour the children bathroom. LPA Bailey observed children safety latches on the bathroom cabinet. LPA Bailey did not observe any hazardous items in the bathroom. At 11:00 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 provides breakfast, lunch and snack. At 11:06 am LPA Bailey observed age appropriate toys and napping equipment on the premises.

At 10:55am LPA Bailey tour the children bathroom. LPA Bailey observed children safety latches on the bathroom cabinet. LPA Bailey did not observe any hazardous items in the bathroom.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE: DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/18/2022
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 2
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: PERGES AND LEAVELL FAMILY CHILD CARE
FACILITY NUMBER: 197405743
VISIT DATE: 02/18/2022
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At 11:10 am LPA Bailey toured the back yard observed that all areas are adequately fenced and was inspected for hazards.

At 11:12 AM LPA Bailey reviewed the Disaster Plan; Emergency Disaster Drill were reviewed. LPA Bailey observed a Fire & Earthquake drill on 02/04/2022. A current Children roster was viewed and maintained for a period of 3 years, even after children no longer are attending the facility.

Licensee has mandated reporter training expired 01/19/2024. Licensee PED F/A & CPR EXP. 06/01/2022



Licensee 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 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.

At 11:26 AM Licensee Perges was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation.

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. *

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 were provided. LPA discussed and provided a copy of PIN 20-24-CCP.

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

DATE: 02/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2022
LIC809 (FAS) - (06/04)
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