197495184-9-20-2022-30-CC-ARIR-CJFSLW-20220920135902

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 197495184
Report Date: 09/20/2022
Date Signed: 09/20/2022 01:59:13 PM

Document Has Been Signed on 09/20/2022 01:59 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:	BROWN FAMILY CHILD CARE		FACILITY NUMBER:	197495184
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	09/20/2022
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Daniel Brown, Licensee		TIME COMPLETED:	02:15 PM

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On 09/20/2022, Licensing Program Analyst (LPA), Adrian Risher conducted a pre-licensing inspection for a family child care home. LPA met with applicant Daniel Brown 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 Sunday to Saturday. Applicant is requesting to have a family child care home with a capacity of 8.

The single family home has 4 bedrooms and 2 1/2 bathrooms. The daycare will consist of the living room and bedroom 1. These areas were inspected by LPA. The other bedrooms and rooms are considered off-limits and inaccessible. The living room will be used for daily activities, napping and eating. Bedroom 1 will be sued for napping infants. Applicant will use cots and play pens for napping.

Applicant is renting the home. Applicant provided property owner/landlord consent form with the application. The parents will enter the home from the back entrance. 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 and also has a safety gate at the door of the dining room area. The dining room will be used as the isolation area for ill children.

LPA observed age appropriate toys, furniture and activities for children while in care at the facility. There was no body of water. LPA observed a fenced outside play area.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 197495184
	VISIT DATE: 09/20/2022

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LPA observed a charged fire extinguisher (2-A:10-B:C). LPA tested the smoke detector and carbon monoxide detector. Applicant does not have a first aid kit or a thermometer. The home has central air and heat. Per the applicant, there are no firearms on the premises. Applicant reports that there are no pets in the home. LPA did not observe any baby walkers, exersaucers or bouncers.

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. LPA reviewed LIC311d with applicant.

Applicant has current CPR, first aid, health and safety which expires 06/2024. Applicant provided copies of immunization records and mandated reporter training certificate.

The following documents were received during inspection: LIC279b, LIC9149, applicant's proof of MMR, LIC9108 for applicant & assistant, assistant: LIC508, mandated reporter certificate, preventative health & safety & cpr card exp 072024

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

1. first aid kit
2. thermometer

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 09/20/2022. 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: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

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: BROWN FAMILY CHILD CARE	FACILITY NUMBER: 197495184
	VISIT DATE: 09/20/2022

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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 Daniel Brown.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Adrian Risher
LICENSING EVALUATOR SIGNATURE:	DATE: 09/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2022

LIC809 (FAS) - (06/04)

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