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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197405926
Report Date: 06/27/2022
Date Signed: 06/27/2022 08:25:40 PM

Document Has Been Signed on 06/27/2022 08:25 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:MASSEY FAMILY CHILD CAREFACILITY NUMBER:
197405926
ADMINISTRATOR:MASSEY, CAROLFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 291-0595
CITY:LOS ANGELESSTATE: CAZIP CODE:
90043
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: DATE:
06/27/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:21 AM
MET WITH:Carol Massey and LaShawn MasseyTIME COMPLETED:
01:30 PM
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On 6/27/2022 Licensing Program Analyst (LPA), Judy Laureano conducted an unannounced Annual Required Inspection and was met by Assistant, La Shawn Massey and Licensee, Carol Massey. LPA observed 5 children in the home with 1 additional adult during the inspections. Days and hours of operation are Monday through Friday, 24 hours a day and Saturday 8 am to 6:00 p.m. Facility is available for overnight care but currently does not have any children enrolled for overnight care.

LPA toured the home inside and outside and a census was taken. Current facility sketch reviewed, and Licensee confirmed the living room is use for the day care. Families access the day care room through the main entrance. Home is a two story dwelling with a bedroom, bathroom and patio in the second floor, living room, bathroom, kitchen, dining room, den/family room, ½ bathroom and laundry room. Licensee confirmed the following areas are OFF LIMITS: kitchen, dining room, den/family room, ½ bathroom, laundry room and the second floor. LPA observed a safety gate at the entrance of the kitchen making the area inaccessible. The den/family room is used as a walk way to access the backyard. Children do not walk through the areas without supervision.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises. No poisons were observed during the inspection. Detergents, cleaning compounds are stored under the kitchen sink cabinet that was observed with a safety latch and in the laundry room which has been designated as OFF LIMITS. LPA observed the laundry room door closed.

LPA observed two fire places located in the den/family room and in the bedroom located in the second floor, both areas are OFF LIMITS to the children in care and are covered by a mesh gate. No open face heaters were observed in the home.
There is a working fire extinguisher, smoke detector, carbon monoxide detector and adequate heating and ventilation for safety and comfort.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/27/2022
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: MASSEY FAMILY CHILD CARE
FACILITY NUMBER: 197405926
VISIT DATE: 06/27/2022
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Safe toys and play equipment are observed. The home has working telephone service and LPA confirmed the phone number is 323-291-0595.

There are currently no infants in care and/or enrolled in program. Licensee and Assistant confirmed that facility is open to enrolled infants. LPA discussed Safe Sleep Regulations with licensee. There is one crib or play yard for each infant in care, cribs and play yards are 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 physically checks on sleeping infants every fifteen minutes and documents 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 will be completed and in file for each infant up to 12 months of age when enrolled. Infants up to 12 months of age are placed on their backs for sleeping.

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. The outdoor play area in the backyard is fenced and there are no hazards to children present. LPA observed a shaded deck area and cemented yard with age appropriate toys. LPA observed a detached garage that has been designated as OFF LIMITS. Licensee and assistant confirmed the area is locked during the hours of operations. Capacity as specified on the license is being maintained.

LPA reviewed a sample of children’s files and observed files were complete with emergency information as required. Licensee’s Mandated Reporter Training was not available for review and Licensee and Assistant confirmed that proof of completion will be emailed to LPA by 7/11/2022. Licensee’s pediatric CPR/First Aid expires on 7/28/2023. A review of records indicates that all employees and/or volunteers have immunization records on file for influenza, pertussis and measles. Licensee and assistant will ensure all file include all necessary documents reflected on the LIC 311D.

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.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
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, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MASSEY FAMILY CHILD CARE
FACILITY NUMBER: 197405926
VISIT DATE: 06/27/2022
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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.

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.

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.

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 Carol Massey and assistant LaShawn Massey.
SUPERVISORS NAME: Claudia Escobedo
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2022
LIC809 (FAS) - (06/04)
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