198003995-6-6-2024-33-CC-SLII-D5YUDH-20240606152935

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198003995
Report Date: 06/06/2024
Date Signed: 06/06/2024 03:29:48 PM

Document Has Been Signed on 06/06/2024 03:29 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	BOOKER FAMILY CHILD CARE		FACILITY NUMBER:	198003995
ADMINISTRATOR/ DIRECTOR:	BOOKER, RAYMOND		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(909) 399-5935
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 17	CENSUS:	DATE:	06/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:35 PM
MET WITH:	Licensee Raymond Booker		TIME VISIT/ INSPECTION COMPLETED:	03:45 PM

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 6/06/24 at 1:30pm, Licensing Program Analysts (LPA) Stephanie Li conducted an unannounced required 3 year inspection to the above facility. A risk assessment was conducted upon entry. LPA met with Licensee Raymond Booker, who guided analyst on a tour of the facility. There was 9 children and 3 adult present during visit. Per Licensee, there is currently 17 children enrolled. A current children’s roster was available for review. This is a two story home which consists of 7 bedrooms, 4 restrooms, living room, preschool room, kitchen, back yard, garage and side yard (fenced). The children have access to preschool room, 3 bedrooms, 2 bathrooms, and back yard. The licensee states that 2 adults and 1 children currently live in the home. Per Licensee there are no firearms or weapons stored in the home. No bodies of water was observed. Per licensee, areas off limits to children and parents include 4 bedrooms, 2 restroom, living room, side back yard, and garage. LPA toured all areas used by children during this visit. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection. Cleaning compounds, and medications were observed to be inaccessible to children. Per licensee, there are no poisons kept in the home. The restroom that children use was observed to be safe and sanitary. There is telephone service via cellphone that stays at the facility during operation hours. The home is observed to be clean and orderly with central air and heat. There are toys available for children. Napping cots and playpens were observed in the child care room. Page 1 of 3

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BOOKER FAMILY CHILD CARE	FACILITY NUMBER: 198003995
	VISIT DATE: 06/06/2024

NARRATIVE

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At 2:20pm, LPA observed the required 2A 10BC fire extinguisher with purchase receipt dated 5/2022 available for review. LPA advised licensee that per State Fire Marshall standards that fire extinguishers shall be serviced annually and if self purchasing to keep the receipt with the fire extinguisher. Per Licensee, they will purchase a new one and keep a receipt with it. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill was conducted in 6/05/24. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board in the classroom.

Currently, children are using the back yard for outdoor play time. The outdoor play area was observed to be fenced. LPA observed the outdoor yard to have appropriate toys and other materials for children to use. LPA observed a couple toys that were broken and advised to store those items in the off limits area. The licensee is observed to be operating within the license capacity limitations.

At 2:40 pm, children and adult records were reviewed, including emergency information and were observed to be complete. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee Pediatric First Aid and CPR expired on 09/2025 . There are first aid supplies available. Licensee has completed the Mandated Reporter AB 1207 Training Certificate expiration date 3/28/2022. LPA advised that mandated reporter training certificate is renewable every two years. A citation is being issued, see LIC809D page.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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: https://www.ada.gov/resources/child-care-centers/.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BOOKER FAMILY CHILD CARE	FACILITY NUMBER: 198003995
	VISIT DATE: 06/06/2024

NARRATIVE

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LPA discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment. Safe sleep PIN provided for review.

Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Megan’s Law - Family Child Care Homes During the exit interview, the Licensee Maria Tovar, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

MyChildCarePlan.org – Centers and Family Child Care Homes Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on Licensing staff observations and records review, the following deficiencies listed on the attached LIC 809D (deficiency page) are being cited in accordance with California Code of Regulations Title 22. Deficiencies that are being cited need to be cleared to protect the children’s health and safety.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Licensee Raymond Booker.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 06/06/2024 03:29 PM - It Cannot Be Edited

Created By: Stephanie Li On 06/06/2024 at 03:06 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: BOOKER FAMILY CHILD CARE	FACILITY NUMBER: 198003995
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above in one staff did not have the required renewal of mandated reporter training certificate, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Per licensee, staff will complete mandated reporter training and email certificate to LPA via email by 6/14/24.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Christina Gabelman

LICENSING EVALUATOR NAME:

Stephanie Li

LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024

LIC809 (FAS) - (06/04)

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