197495169-9-22-2022-30-CC-ARIR-CJHQMP-20220922121753

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495169
Report Date: 09/22/2022
Date Signed: 09/22/2022 12:18:07 PM

Document Has Been Signed on 09/22/2022 12:18 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:	BAKER FAMILY CHILD		FACILITY NUMBER:	197495169
ADMINISTRATOR:	BAKER, SHARON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 532-8764
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90047
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/22/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Sharon Baker, Applicant		TIME COMPLETED:	12:40 PM

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On 09/22/2022, Licensing Program Analyst (LPA), Adrian Risher conducted a pre-licensing inspection for a family child care home relocation. LPA met with applicant Sharon Baker and toured the facility. The applicant is the only individual present at the time of the inspection. LPA did not observe any children present. The home is clean, orderly and comfortable. All adults in the home have been fingerprinted and associated to the facility. The hours of operation will be 23 hours Monday thru Friday.

Applicant is requesting to have a family child care home with a capacity of 14. Fire Inspector Henry Medina granted the fire clearance for capacity of 14 on 09/15/2022. Inspector Medina provided the grant with the following conditions: rear converted room requires 1. a second door, 2. fire alarm, 3. fire extinguisher and 4. exit signs above each door in order to be occupied. Applicant was reminded that this area is off-limits until these corrections are completed.

The single family home has 3 bedrooms and 2 bathrooms. The daycare will consist of living room and bedroom 3. These areas were inspected by LPA. Applicant stated the living room will be used for daily activities, napping and eating. Bedroom 3 will be used for overnight care. The other bedrooms and rooms are considered off-limits and inaccessible. Applicant owns the home. Applicant provided a copy of the deed of trust.

Applicant stated the parents will enter the home from the front door. LPA inspected the bathroom and did not observe any medications or poisons that could pose a potential risk to children in care. The kitchen was inspected during the visit. LPA did not observe any knives or sharp objects, detergents or cleaning supplies that would pose a potential risk to children in care. These items were made inaccessible to the children. Licensee has put safety locks on the lower cabinets in the kitchen. The living room will be used as the isolation area for ill children.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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: BAKER FAMILY CHILD	FACILITY NUMBER: 197495169
	VISIT DATE: 09/22/2022

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LPA observed age appropriate toys, furniture and activities for children while in care at the facility. Applicant will place a safety gate in the yard to keep the children in the grassy area in the backyard. LPA Risher did not observe any bodies of water. The outside play area is fenced all around.

LPA observed a charged fire extinguisher (2-A:10-B:C). LPA tested the smoke detector and carbon monoxide detector. Applicant has a first aid kit which includes band aids and a thermometer. The home has 2 screened wall-heaters. . A portable air conditioner may be used for ventilation. Applicant stated that she will open windows during the warmer weather as well. LPA did not observe any baby walkers, exersaucers or bouncers.

Applicant has current CPR, first aid, health and safety which expires 05/23/2023. Per the applicant, there are no firearms on the premises. Applicant reports that there are no pets in the home. Applicant provided a copy of the immunization record. Applicant needs to provide a copy of the mandated reporter certificate.

The parent board will be posted for parents to view required information such as the license, parent's rights poster, personal rights, and emergency disaster plan. A copy of the children's roster will be kept accessible.

The following documents were received from applicant: 1. Copy of Deed of trust 2. Pre-licensing Readiness Guide 3. Current Children in the home 4. Criminal Background Clearance Transfer Request

The following corrections were discussed with applicant in order for the home to be ready for conducting child care:

1. Mandated Reporter Certificate

A license to operate a Small Family child care home will be reviewed following final administrative review, and receipt of outstanding corrections needed. No license will be issued today 09/22/2022. Applicant will notify LPA when corrections have been made, and the Applicant has 30 days to complete corrections.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

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: BAKER FAMILY CHILD	FACILITY NUMBER: 197495169
	VISIT DATE: 09/22/2022

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Applicant was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 applicant 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 applicant 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) 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/child1qanda.htm

LPA reviewed with applicant the LIC 311D, Forms/Records To Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform.

To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Exit interview conducted and report was reviewed with the applicant Sharon Baker.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 09/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2022

LIC809 (FAS) - (06/04)

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