197494181-5-6-2024-33-CC-SSAN-D4ZPS9-20240506113359

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494181
Report Date: 05/06/2024
Date Signed: 05/06/2024 11:34:09 AM

Document Has Been Signed on 05/06/2024 11:34 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	KAYE FAMILY CHILD CARE		FACILITY NUMBER:	197494181
ADMINISTRATOR/ DIRECTOR:	KAYE, CHAYA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 593-3951
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90036
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 12	DATE:	05/06/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Chaya Kaye		TIME VISIT/ INSPECTION COMPLETED:	11:55 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	On 05/06/2024, at 09:00 am Licensing Program Analysts (LPAs) Shushanik Safaryan and Priscilla Ochoa conducted an unannounced annual random inspection to the above facility. LPAs met with Licensee, Chaya Kaye, to whom the reason for the visit was explained. Per Licensee, there are 12 children currently enrolled. There were 12 children and one adult (licensees’ assistant) Teresita Chavez present upon arrival. Nora Freedman, volunteer in the day care , came in later .The licensee was observed to be operating within the license capacity limitations. The licensee states that 2 adults and 3 children currently live in the home. All adults living in the home have obtained a criminal record clearance. This is a one -story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, office,family room, front yard and backyard (fenced). Per Facility Representatives parents drop off their children from the back alley which enters directly to the back yard .Children have access to the back yard, which is fenced , bathroom located next to the sliding doors and living room . Areas inaccessible to the children are bedrooms , bathroom in the bedroom , office ,kitchen and front yard. To go to the living room children, pass through the kitchen . LPAs observed latches on the kitchen cabinets with any potentially hazardous material. The LPAs toured all areas used by children starting from the back entrance during this visit. All areas identified that are accessible for children to use were inspected for the safety, comfort, and cleanliness. At 09:15 am Licensee guided LPAs to the tour of the home. LPAs were toured starting from the back entrance from the alley , where parents enter and observed all the required postings and publications Facility License, Emergency Disaster Plan, Parent’s Rights Poster, and Earthquake Preparedness Checklist. Next LPAs toured the back yard, which is fenced and observed turf , playing equipment , little cars , toys , tables , chairs , art supplies . Page 1of 4

SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KAYE FAMILY CHILD CARE	FACILITY NUMBER: 197494181
	VISIT DATE: 05/06/2024

NARRATIVE

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Currently, children are using the backyard for outdoor play time. The outdoor play area was observed to be fenced and gated. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose danger to children. No bodies of water were observed on this day.

Then LPAs toured the bathroom for children`s use and did not observe any hazards . Children use the living room for activities where LPA observed little chairs , tables , toys . Per licensee children in care don’t nap . LPAs observed safety latches on the door leading to the off-limit areas .
A current children’s roster was available for review.
There is telephone service via a cellphone that stays at the facility during operation hours. Hours of operation are Monday – Friday, 08:30 am – 03:00 pm. There is central air and heating in the home.

Detergents, cleaning compounds, and medications were observed to be inaccessible to children. LPAs observed medications and first aid supplies in the kitchen cabinet inaccessible to the children . Per Licensee, there are no poisons in the home. LPAs advised that any poisons should be locked under key or combination lock.
At 09:30 am Licensee states that there is firearm stored in the home separate from ammunition and inaccessible to the children .(Declaration Obtained ) .LPAs took pictures see LIC 812 .

The valve on the required 2A 10BC fire extinguisher indicates fully charged and LPA observed service tag with the service date 01/05/2024. Smoke and carbon monoxide detectors were tested and are operable.

All homes shall conduct fire and disaster drills at least once every six months and document the date nd time of each drill. Last drill documented was conducted on 03/28/2024.

The home is observed to be clean and orderly. There are age-appropriate toys available for children.

Per licensee, she provides food for children in care. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with child’s name and properly stored or refrigerated.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

LIC809 (FAS) - (06/04)

Page: 2 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KAYE FAMILY CHILD CARE	FACILITY NUMBER: 197494181
	VISIT DATE: 05/06/2024

NARRATIVE

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At 10:00 am Licensee and staff records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 01/05/26.
LPAs observed that the Licensee does have proof of Mandated Reporter AB 1207 compliant Child Care Training Certificate on file with expiration on 01/05/26. www.mandatedreporterca.com

At 10:30 am LPAs observed that Licensee`s Assistant is missing proof of immunization.(Pertussis , MMR ). Per licensees Assistant she had the vaccines prior in the different country but was unable to provide proof of the vaccine . Children’s records were reviewed, including emergency information and were observed to be complete. Licensee states she is currently caring for only 1 infant, her own child .
LPAs created an LIC 857, Children’s Record Review, and LIC 859, Staff Record Review which documents staff and children’s files reviewed during this inspection.
Per licensee, there are no animals on the premises.

Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, and/or any other item that fall into these categories are not permitted in a family childcare facility.

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/.

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.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

LIC809 (FAS) - (06/04)

Page: 3 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 CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KAYE FAMILY CHILD CARE	FACILITY NUMBER: 197494181
	VISIT DATE: 05/06/2024

NARRATIVE

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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days 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.

LPA advised the licensee how to access forms, regulations and quarterly updates on the Child Care Licensing website at www.ccld.ca.gov.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California

During the exit interview, the LICENSEE Chaya Kaye confirmed that there are no Registered Sex Offenders living in the facility .

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health & safety.

An exit interview was conducted, and a copy of this report was provided along
with Appeal Rights to Chaya Kaye on 05/06/24.

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.

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SUPERVISORS NAME: Claudia Guangorena
LICENSING EVALUATOR NAME: Shushanik Safaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 05/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 05/06/2024 11:34 AM - It Cannot Be Edited

Created By: Shushanik Safaryan On 05/06/2024 at 11:09 AM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: KAYE FAMILY CHILD CARE	FACILITY NUMBER: 197494181
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.622(c)

Administration of Child Day Care Licensing

(c) The family day care home shall maintain documentation of the required immunizations or exemptions from immunization, as set forth in this section, in the person's personnel record that is maintained by the family day care home. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observations , record review and interview the licensees assistant did not comply with the section cited above. LPAs reviewed the assistant record and did not see proof of immunization required . Licensees assistant missing Pertussis, MMR vaccines , which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/20/2024
	Plan of Correction
1 2 3 4	Licensee will email proof of immunization to the LPA by POC date .

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Claudia Guangorena

LICENSING EVALUATOR NAME:

Shushanik Safaryan

LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024

LIC809 (FAS) - (06/04)

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