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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197495427
Report Date: 08/07/2024
Date Signed: 08/08/2024 12:42:19 AM

Document Has Been Signed on 08/08/2024 12:42 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:MINOR BROWN FAMILY CHILD CAREFACILITY NUMBER:
197495427
ADMINISTRATOR/
DIRECTOR:		ALICIA & TORI MINOR BROWNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 257-2760
CITY:GARDENASTATE: CAZIP CODE:
90248
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 0DATE:
08/07/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Alicia Minor BrownTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
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On August 7, 2024, Licensing Program Analyst (LPA) V. Wheatley conducted an announced Prelicensing inspection for the purpose of a new license. The meeting was to ensure that health, safety and personal rights, as required by Title 22 Regulations governing California Family Child Care Homes, will be met by the applicant, Alicia Minor Brown for a new license. The other co-applicant Tori Minor Brown was not present.

The applicants submitted an application for a Large Family Child Care Home however the applicants have decided to reduce to a Small Family Child Care Home. This license will be for a maximum capacity for six children – no more than three infants. Applicant was reminded that all adults living in the home or working must obtain criminal record clearances.

LPA Wheatley met with applicant and was guided on a tour of the inside and outside of the home. The home is 2-story house with three bedrooms and three bathrooms. The entire upstairs is off-limits and there is a child proof gate at the bottom of the stairs. The facility sketch identifies the primary care for children will be allowed in the living room and the den. In addition, the children will utilize the outdoor backyard area.

LPA Wheatley observed the following:
*Fire safety requirements: Fully charged fire extinguisher (Classification: 2A10BC), 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, and childhood nutrition training.
*Toys and equipment are observed and in good repair
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE: DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/07/2024
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
CCLD Regional Office, 300 CONTINENTAL BLVD. STE 290A
EL SEGUNDO, CA 90245
FACILITY NAME: MINOR BROWN FAMILY CHILD CARE
FACILITY NUMBER: 197495427
VISIT DATE: 08/07/2024
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* The home is equipped with a first-aid kit: Cleansing pads, band aid, bandages, gauze, and a digital thermometer
*Child proof electrical outlets were observed
*Applicant states there are no firearms on the premises.
*Applicant sates there are no pets on the premises.
*LPA did not observe any bodies of water.
*Requirements for fire drills, earthquake drills, and documentation for both.
*The role and responsibilities of being a mandated reporter.
*Mandatory Forms for the children’s files. Records must be kept for 3 years after termination.
*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
*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. LPA discussed the influenza waiver during the inspection.

SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
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: MINOR BROWN FAMILY CHILD CARE
FACILITY NUMBER: 197495427
VISIT DATE: 08/07/2024
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*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 (IMS) 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 infants must be placed on their backs when sleeping to prevent S.I.D.S. (Sudden Infant Death Syndrome) Applicant was informed that all provider is required to wash hands after every diaper change and to never shake a baby to prevent the Shaken Baby Syndrome. Safe to Sleep Campaign:

https://safetosleep.nichd.nih.gov/materials19-02 CCP Safe Sleep Awareness Campaign



*Isolation area will be in one of the day care rooms and the ill child will be separated from other children.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
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: MINOR BROWN FAMILY CHILD CARE
FACILITY NUMBER: 197495427
VISIT DATE: 08/07/2024
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CAPACITY LICENSE: While operating as a small family childcare home Applicant may operate with 4 infants only. Maximum Capacity 6 children with no more than 3 infants and 3 children over the age of 2 years old.

*Requirements for fingerprint clearances and associations are discussed with the applicant. The applicant was informed that the presence of adults in the home without Criminal Record Clearance or Exemption will be cited and civil penalty assessed for $100 per day up to $500.00 (5 days) for the 1st offense and up to $3000.00 for the 2nd offense within a 12-month period. The applicant may find additional information and forms on the Department’s website at www.ccld.ca.gov including information on the Live Scan application (LIC 9163). Appointments can be made for Live Scan at 1-800-315-4507.

*LPA informed applicant how to obtain P.I.N.S. and Quarterly Updates. Applicant was encouraged to read the PINS and Child Care Quarterly updates, as they come out, to stay informed of any changes or updates to statutes and regulations. 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 and email address: childcareadvocatesprogram@dss.ca.gov

*The applicant was advised of the requirement to report unusual incidents and/or injuries to the parent/guardian and licensing within the time frame specified by the regulation (LIC 624B)

*LPA discussed AB633 and informed applicant that upon receipt of a Type A deficiency, the applicants shall post and provide copies of this licensing report (LIC 809 or LIC 9099 and copy of LIC 9224 parent/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. If these requirements are not met, civil penalties in the amount of $100 per violation will be assessed.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: MINOR BROWN FAMILY CHILD CARE
FACILITY NUMBER: 197495427
VISIT DATE: 08/07/2024
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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
Children’s Records Requirements:
LIC 700 Identification and Emergency Information
LIC 627 Consent for Emergency Medical Treatment
LIC 282 Affidavit Regarding Liability Insurance
LIC 9150 Parent Notification Additional Children in Care
LIC 9166 Consent/Verification for Nebulizer Care
CDPH 286 (Immunization Blue Card) with Immunization record
PUB 72- Family Child Care Consumer Guide
LIC 995A Notification of Parent’s Rights
LIC 995E Caregiver Background Check Process
LIC 9212 Family Child Care Consumer Awareness Information
PM 286 California School Immunization Record (blue card)-http://www.dhs.ca.gov/publications/forms/immunization.htm
LIC 9227 - Sleeping Plan (for infants under 1 years of age)
LIC 9224 Acknowledgement of Receipt of Licensing Report, when applicable.
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
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
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: MINOR BROWN FAMILY CHILD CARE
FACILITY NUMBER: 197495427
VISIT DATE: 08/07/2024
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The applicants have no submitted a signed Landlord Consent Form. Therefore a license will be granted for 6 maximum capacity when the following items have been corrected:

1. Two closets door knobs covered or a latch installed
2. Television cord covered in the den
3. Napping cots or mats
4. Rose bush in the backyard removed or fenced
5. Parent Board with required forms
6. Photos of applicant's son bedroom. The door was locked during the inspection.

The corrections will be submitted to the Department by email by August 14, 2024.

Exit interview conducted. A copy of the report was read and provided to the applicant.
SUPERVISORS NAME: Maureen Neal
LICENSING EVALUATOR NAME: Veronica Wheatley
LICENSING EVALUATOR SIGNATURE:

DATE: 08/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2024
LIC809 (FAS) - (06/04)
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