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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197494665
Report Date: 03/29/2022
Date Signed: 04/01/2022 09:08:40 AM

Document Has Been Signed on 04/01/2022 09:08 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:LUU FAMILY CHILD CAREFACILITY NUMBER:
197494665
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 4DATE:
03/29/2022
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Josephine LuuTIME COMPLETED:
12:00 PM
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On 3/29/2022 at 9:00 am, Licensing Program Analyst (LPA) Judy Laureano conducted an announced inspection with Josephine Luu for the purpose of an increase of capacity inspection for 10908 Whitaker Avenue, Granada Hills, CA 91344. The purpose of this increase of capacity visit is to ensure the standards for a Family Child Care Home are being met in accordance to California Tittle 22 Regulations and California Health and Safety Codes.

The licensee is applying for an increase of capacity; Large Family Child Care Home license for a max capacity of 14. A fire clearance was approved by LA County Fire Department on 1/27/2022. Facility was licensed for a Small (8) Family Child Care Home on 12/18/2020.

The capacity of the Large Family Child Care Home is 14. Per the application, at this time, the ages the applicant wishes to provide services for are children birth to 5 years old with the hours of Monday- Friday from 7:00 a.m. to 6:00 p.m. Licensee was informed that any changes to ages, hours and days of operation shall be submitted to the department for approval prior to initiation of changes.

The home is a single story, 5 bedrooms, 4-bathroom house, with a living room, dining room, kitchen, breakfast area and attached garage. Attached garage is accessible through bedroom 2. Currently residing in the home is licensee and 4 other adults.

Parents enter the home through main door. Front yard is not gated and is OFF LIMITS to the children in care. Entering the front door, LPA observed the Fire Alarm pull station and Parent board. LPA discussed all necessary forms that need to be included on the board.

LPA observed a small hallway that leads you to bedroom 1, that has been designated as the isolation room and/or sick room. LPA observed area to have all electric outlets covered.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE: DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/29/2022
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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665
VISIT DATE: 03/29/2022
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LPA observed applicant test the carbon monoxide detector located in the hallway.

Next to Bedroom 1, bedroom 2, bathroom 2 and bedroom 3 were observed and designated to be OFF LIMITS to the children in care. Applicant confirmed that doors will remain locked during the hours of operations.

The kitchen area was observed to have a Fire Extinguisher, purchased 1/18/22, mounted on the wall. The stove was observed to have plastic covers on the knobs. Refrigerator sink and counter space area were observed and inspected. Knifes and sharp object were observed to be made inaccessible to the children in care. Applicant confirmed that facility will be providing meals and snacks. Kitchen has a closet that is used for storage for the program. LPA discuss food preparation, storage and ensuring a log and information regarding dietary restrictions and allergies are kept up to date. As a COVID precautions, LPA advised applicant to use disposable paper good. Kitchen is used as a walkway to access the bathroom that children use and it also gives access to the second emergency exit.

Outside the kitchen, LPA observed a changing table station located outside the bathroom. Bathroom was observed to have a toilet, sink and under the sink cabinet. All electric outlets were covered and cabinet under the sink was secured with a safety latch. LPA discussed COVID-19 recommendation such as using paper towels and displaying a handwashing sign for children to view.

Outside the kitchen, LPA observed the living room and dinning room area which has been designated as an additional napping area and day care area. LPA observed two couches, a television set and entertainment unit and a coffee table. Area was inspected to be free of hazardous materials. Next to the living room, LPA observed the dining room area to have a dining room set; 4 chairs and a table. LPA observed applicants test the smoke detector located in the dining room area.

The living room and dinning area led you the Family Room that has been designated as the daycare area. LPA observed a child safety gate at the entrance of the area. LPA observed a variety of age appropriate materials, children’s size tables and chairs, three high chairs

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665
VISIT DATE: 03/29/2022
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and 3 pack and plays. The area was observed to have children’s size cubbies with a variety of blocks. LPA observed a fireplace with a glass door secured with a zip tie located in the family room. Applicant confirmed fire place is not used during the program’s hours of operation. There are three stairs from the living room to the family room. Stairs are barricaded by the use of a child safety gate.

The outdoor area is accessed through the main entrance. Applicant confirmed that children are walked to the side area of the home. LPA observed a self latching gate enclosed the area. The outdoor area is cemented and LPA observed a variety of age appropriate outdoor toys. Applicant confirmed when it gets hot, a tarp/canopy is set up to provide a shaded area for children.

There is no swimming pool or other bodies of water on the premises. There are no firearms or ammunition on the premises.

Facility was observed with two guest houses in the back of the home. Applicant stated they were studio size guest houses rented out by the owner of the property with two separate tenants. Tenants have access to the guest house though a gate on the right side of the home. Guest house is attached to the main home with no access from inside the main home. Children’s outdoor play area is located on the left side of the home with a child safety gate preventing access to the guest houses.


The following areas are OFF LIMITS to the children in care:
1. Bedroom 2 and Bedroom 3- door will remain locked during the hours of operations.
2. Bathroom 2- door will remain locked during hours of operations.
3. Two Studio apartments located in the back of the home with its own entrance and exit.
4. Attached garage

No corrections were observed during today’s inspections. Exit interview was conducted with applicant Josephine Luu. The licensing determination of this application will be reviewed with Licensing Program Manager for final resolution.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665
VISIT DATE: 03/29/2022
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The following was discussed with the applicant:
Applicant was made aware of The Child Care Advocate Program (CCAP) that is administered from within the Community Care Licensing Division. CCAP participates in many community activities and special projects in order to disseminate information on the State’s licensing role, provide information to the public and parents on childcare licensing, and provide many other helpful resources to the licensees and the public. CCAP’s direct contact information is as followed: Phone number: (916) 654-1541
Email Address: childcareadvocatesprogram@dss.ca.gov

Immunizations: 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. LPA discussed the influenza waiver during the inspection.

Mandated Reporter Training: 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. Volunteers are encouraged but not required to take the training. Website: www.mandatedreporterca.com. Licensee was reminded of their responsibility to report suspected child abuse.


Mandatory Forms for the children’s files and provider’s files were discussed. Applicant was referred to LIC 311D: Records To Keep in Your Family Child Care.

FORMS TO BE POSTED


LIC203 Facility License
LIC 610A Emergency Disaster Plan
LIC 9148 Earthquake Preparedness Checklist
PUB394 Notification of Parents Rights Poster
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665
VISIT DATE: 03/29/2022
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Facility Records:
LIC 624B Unusual Incident/Injury Report
LIC 9040 Child Care Facility Roster
LIC 9052 Employee Rights,
LIC 9108 Statement Acknowledging Requirement to Report Child Abuse
LIC 9149 Landlord Consent Form, if you plan to care for more than 6 for Small or 12 for Large
LIC 9151 Property Owner/Landlord Notification Form
Personnel Records as required in Tittle 22, Division 12, Chapter 3, Section 102416.1, including but not limited to proof of current pediatric CPR and First Aid Certificates, Preventative Health certificate and criminal record information.
Copy of your deed or lease/rental agreement
Documentation of Fire and Disaster drill
Proof of immunization's against pertussis (TDAP), measles (MMR), and influenza
Mandated Reporter certificate – www.mandated reporterca.com – renewed every two years.

Licensee was made reminded that it is the licensee’s, as well as anyone who assists in providing care responsibility to know the regulations. Licensee was also encouraged to read the Child Care quarterly updates every season as they come out to stay informed of any changes or updates to statutes and regulations.

Applicant was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation.



Applicant was made aware that state law prohibits baby walkers, bouncy seats, exer-saucers and any other items that fall into that category. Applicant was also reminded that only children who are eating may be in highchairs and that car seats are utilized only for transportation.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
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: LUU FAMILY CHILD CARE
FACILITY NUMBER: 197494665
VISIT DATE: 03/29/2022
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LPA discussed the safe sleep regulations with Licensee 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 Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, including staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, 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.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Judy Laureano
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022
LIC809 (FAS) - (06/04)
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