197418150-8-14-2024-54-CC-KCHE-D85SWW-20240814141501

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197418150
Report Date: 08/14/2024
Date Signed: 08/14/2024 02:15:13 PM

Document Has Been Signed on 08/14/2024 02:15 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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	MOORE FAMILY CHILD CARE		FACILITY NUMBER:	197418150
ADMINISTRATOR/ DIRECTOR:	MOORE, ADRIENNE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 240-5655
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 0	DATE:	08/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:15 PM
MET WITH:	Adrienne Moore, Licensee		TIME VISIT/ INSPECTION COMPLETED:	02:30 PM

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	On 08/14/2024 at 12:40 PM, Licensing Program Analysts (LPAs) Katrina Chicote and Peter Bishop conducted an Unannounced Annual/Random inspection to the above facility. Upon arrival, LPAs disclosed the purpose of the inspection and met with Licensee, Adrienne Moore, who guided the LPAs on a tour of the facility. Adults in the home were discussed and all have criminal record clearance. There were no day care children present during today’s inspection. Licensee states that there are currently 12 children enrolled which includes one infant. The children's roster was reviewed and is current. Per Licensee, the facility’s hours of operation are 23 hours seven days a week. Licensee does understand license limitations of not providing care to children longer than 23 hours. Required postings were observed. Disaster drill log was also available during today’s inspection. Per Licensee, they conduct monthly drills though last disaster drill logged observed by LPA is 09/12/2023. LIC 126 was provided. This is a single story home which consists of two bedrooms, one bathroom, Kitchen, Day Care Room, and Dramatic Play Room. Areas used by the children include the Day Care Room (located upon entry), Dramatic Play Room (located next to Day Care Room), Bathroom 1 (located to the right of Dramatic Play Room), Bedroom 1 used as Baby Room (located to the right of Bathroom 1), and Kitchen (located to the rear of the home). Per Licensee, areas off limits to children and parents include Bedroom 2, which LPAs observed has door which Licensee states remains locked when children are in care. All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home. At 12:43 PM, LPAs observed Day Care Room to have fish tank, art materials and shelves with baskets of a variety of age appropriate toys, free of loose and sharp parts are available. At 12:45 PM, LPAs observed Dramatic Play Room that have play equipment available. At 12:48 PM, LPAs observed Bathroom 1 to have general area safety and sanitation, adequate supplies, and operable equipment at time Report Continues - Page 1 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

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 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MOORE FAMILY CHILD CARE	FACILITY NUMBER: 197418150
	VISIT DATE: 08/14/2024

NARRATIVE

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of inspection. LPAs observed medicine cabinet and cabinet above toilet, that is labeled with cleaning solutions, to have locks requiring a key to open making items inside inaccessible. At 12:51 PM, LPAs observed Baby Room to have a wooden crib in the corner, diaper changing table, and rocking chair. At 12:53 PM, LPAs observed Kitchen, which Licensee states have limited access to. LPAs observed entrance to Kitchen where a baby gate was placed at time of inspection. Licensee stores detergents, cleaning compounds, medications, and other items which can pose a danger to children stored inaccessible in cabinets that have locks requiring key to open. LPAs observation of cabinets confirm locks on cabinets at time of inspection. Licensee states that there are no poisons in the home used to kill vermin/bugs at time of inspection. Licensee states children sleep in both Day Care Room and Dramatic Play Room and use blue cots for napping, LPAs observed blue cots stacked in Dramatic Play Room. Licensee states when she has overnight children she stays in the room with them and remains awake when children are awake.

Per Licensee, the children will have access to backyard for outdoor play which is accessible through Kitchen in backdoor. LPAs observed backyard has grass and adequate perimeter fencing through-out the yard. LPAs observed back house and storage area in backyard that Licensee states is off limits to children. LPAs observed dramatic play area to the right with wooden play equipment, back area with easels and other play equipment. LPAs discussed hazards and trees, shrubs, and plants need to be maintained once children are in care.

Per Licensee, they provide food for children in care and use Day Care Room for eating, which LPAs observed have age appropriate table and chairs available for eating.

LPAs observed four pets at time of inspection, though Licensee states these dogs are only present temporarily and will not be here once they begin operation. Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPAs observation did not see any bodies of water around the premises or firearms/weapons at time of inspection.

At 1:00 PM, LPAs observed the valve on the required 2A 10BC fire extinguisher indicates fully charged with service tag dated 07/09/2024. LPAs tested smoke and carbon monoxide detectors to be operable at time of inspection. Licensee has current Pediatric First Aid and CPR valid until 11/2024 and proof of completion of AB1207 Mandated Reporter completed on 08/18/2023. Proof of immunization against influenza, pertussis, and measles was not readily available during today’s inspection, LPAs discussed requirement.
—Children records and required licensing forms were discussed and reviewed at time of inspection.
Report Continues - Page 2 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

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
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MOORE FAMILY CHILD CARE	FACILITY NUMBER: 197418150
	VISIT DATE: 08/14/2024

NARRATIVE

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The following were discussed:
Rooms that are off-limits need to be made inaccessible during operating hours. NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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: https://www.ada.gov/resources/child-care-centers/.
Report Continues - Page 3 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

LIC809 (FAS) - (06/04)

Page: 3 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: MOORE FAMILY CHILD CARE	FACILITY NUMBER: 197418150
	VISIT DATE: 08/14/2024

NARRATIVE

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MyChildCarePlan.org – Centers and Family Child Care Homes Licensee [or facility representative] was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

During the exit interview, the Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

The facility was found in compliance per Title 22 regulations, there will be no deficiencies only advisories given today, 08/14/2024.

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

Exit interview was conducted and report was reviewed with the Licensee, Adrienne Moore.

Report Ends - Page 4 of 4

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Katrina Chicote
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

LIC809 (FAS) - (06/04)

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