197494659-1-6-2022-30-CC-SMAZ-CAEQFL-20220106110806

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197494659
Report Date: 01/06/2022
Date Signed: 01/06/2022 11:08:21 AM

Document Has Been Signed on 01/06/2022 11:08 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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245

FACILITY NAME:	FURIE FAMILY CHILD CARE		FACILITY NUMBER:	197494659
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 0	DATE:	01/06/2022
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	Licensee Elisa Furie and Cassidy Boesch		TIME COMPLETED:	10:30 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 01/06/2022 at 10:00 AM, Licensing Program Analyst (LPA) Sabrina Martinez conducted an announced Pre-Licensing inspection at 1029 26th St., Santa Monica, CA 90403. Applicant submitted an application for an increased in capacity. Applicant was granted a fire clearance by the Santa Monica Fire Department. LPA Martinez met with Licensee Elisa Furie and Cassidy Boesch and was guided on a tour of the indoor and outdoor of the home. The home is a one-story dwelling with three bedrooms, three bathrooms, living room, dining room, kitchen, front and back yard. All bedrooms are off-limits and made inaccessible to day care children. LPA observed door lever locks on all bedroom door knobs. Licensee is the only resident in the home. Licensee was reminded that all adults living in the home must obtain criminal record clearances. The main day care area shall be conducted in the living room and dining room for daytime activities. Children also have access to bathroom #1. LPA also observed child gates installed making the kitchen area inaccessible to children in care. Chemicals, cleaning supplies, and poisons are kept in the laundry room are inaccessible to children. The back yard shall be made accessible to day care children for outdoor activities. All areas of the home were inspected according to the LIC 999A- facility sketch. LPA Martinez observed the following: Fire safety requirements: Fully charged fire extinguisher (Classification: 3A40BC), smoke and carbon monoxide detectors present and operable. Applicant is currently certified in Pediatric CPR/First Aid and has completed the preventive health and safety training, childhood nutrition training and lead poisoning prevention training. Toys and equipment are observed and in good repair The home is equipped with a first-aid kit: Cleansing pads, band aid, bandages, gauze, and a digital thermometer

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022

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: FURIE FAMILY CHILD CARE	FACILITY NUMBER: 197494659
	VISIT DATE: 01/06/2022

NARRATIVE

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*All toxins and detergents are in locked/latched cabinets
*Home has central heating and air condition
*Electrical outlets have safety covers installed
*Applicant states that there are no guns/weapons in the home
*LPA did not observe firearms and other dangerous weapons during the inspection
*LPA Martinez did not observe bodies of water
*LPA Martinez observed the fireplace screened and inaccessible to children in care

The following items were thoroughly discussed with the applicant:
*Requirements for fire drills, earthquake drills, and documentation for both
*The necessity of earthquake safety and drills twice a year
*The role and responsibilities of being a mandated reporter
*Mandatory Forms for the children’s files and provider’s files
*Applicant was referred to LIC 311D: Records to be Maintained at The Facility - Family Child Care Home.
*Applicant was made aware that it is their responsibility, as well as anyone who assists in providing care, to know Title 22 Regulations.
*The applicant was advised on how to access forms and Regulations for Family Child Care online at www.ccld.ca.gov
*The applicant was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care. Licensing must have the facility’s phone number at all times. If the phone number has changed, licensing must be notified.
*Regulation prohibits the smoking of tobacco on the premises
*State law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category
* All infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome)
*Complaints shall be reported by applicant/licensee and/or parents to the complaint hotline at (844) 538-8766 and for general information and incident reporting; contact their local childcare office. *Commencing September 1, 2016, SB 792, prohibits a person from being employed or volunteering at a childcare facility or family day care if he or she has not been immunized against influenza, pertussis and measles.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022

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: FURIE FAMILY CHILD CARE	FACILITY NUMBER: 197494659
	VISIT DATE: 01/06/2022

NARRATIVE

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LPA discussed the influenza waiver during the inspection.

*Beginning on January 1, 2018, AB 1207, requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every two years. Website: www.mandatedreporterca.com Applicants were reminded of their responsibility to report suspected child abuse.

*Incidental Medical Services Include: Blood-Glucose Monitoring for Diabetic Children, Administering Inhaled Medication, Administering EpiPen Jr. and EpiPen or other Epinephrine Auto-Injectors, Glucagon Administration, Gastrostomy Tube Care (G-tube care), Insulin Injections Administration, Anti-Seizure Administration, and Carrying out medical orders when the child’s physician has determined that a layperson can be trained and safely carry out the orders. Incidental Medical Services (IMS) policy was discussed. 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

*New Appeal Process: A licensee may file an appeal, in writing 15 business days from the date of receiving the penalty assessment. *Applicant was informed of the following items that must be posted in visual site once licensed: (1) License (2) Emergency Disaster Plan (3) Children’s Roster (4) Parents Rights Poster PUB 394, Personal Rights LIC 613-A Recent regulatory changes were discussed.

Below are forms, found at www.ccld.ca.gov, that applicants shall use for record keeping and posting requirements:

LIC 9040 Child Care Facility Roster (Retain for 3 years) most recent must be posted

LIC 9148 Earthquake Preparedness Checklist
LIC 627 Consent for Medical Treatment
LIC 702 Child's Preadmission Health History-Parents Report
LIC 995 Notification of Parent's Rights
PUB 394 Notification of Parent's Rights Poster 12/06 (issued & discussed)

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022

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: FURIE FAMILY CHILD CARE	FACILITY NUMBER: 197494659
	VISIT DATE: 01/06/2022

NARRATIVE

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LIC 613-A Personal Rights
LIC 700 Identification and Emergency Information
LIC 282 Affidavit Regarding Liability for Family Child Care Homes
LIC 9224 Acknowledgement of Receipt of Licensing Reports 12/06 (issued & discussed)
Title 22, Division 12 Regulations (access website: http://ccld.ca.gov)

The facility is found to be in compliance and will be licensed today, 01/06/2022. An exit interview was conducted with the above items discussed and a copy of this report was provided to Licensee Elisa Furie.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Sabrina Martinez
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022

LIC809 (FAS) - (06/04)

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