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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198011765
Report Date: 09/19/2024
Date Signed: 09/19/2024 04:00:25 PM

Document Has Been Signed on 09/19/2024 04:00 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:ANTONINI FAMILY CHILD CAREFACILITY NUMBER:
198011765
ADMINISTRATOR/
DIRECTOR:		ANTONINI, MARLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 922-2636
CITY:LAKEWOODSTATE: CAZIP CODE:
90713
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 11DATE:
09/19/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:02 AM
MET WITH:Marla AntoniniTIME VISIT/
INSPECTION COMPLETED:
02:36 PM
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Licensing Program Analyst (LPA) Jonnisha Culbert performed an unannounced Annual Random Inspection at the facility noted above. LPA met with licensee Marla Antonini and stated the purpose of today’s visit. Licensee guided LPA on a tour of the facility of both indoor and outdoor. Residing in the home are licensee, adult 1, one cat, and one dog. Present at the time of inspection were licensee, assistant 1, and 11 children. At approximately 11:30am assistant 2 arrived at the facility and at approximately 1pm adult 1 arrived.

All areas accessible to children were inspected. This facility is a single-family home that consists of four (4) bedrooms, one (1) bathroom, living room, dining room, kitchen, laundry room, sunroom, garage, and fenced backyard.

Areas that are accessible to children include: two (2) bedrooms, 1 bathroom, dining room, kitchen, living, sunroom, and fenced backyard. Per Licensee, the children utilize the fenced backyard for outdoor activity.

Areas off-limits to children include: 2 bedrooms,laundry room, small area that is fenced in the backyard, and garage. LPA observed child safety knobs installed, making the 2 bedrooms, laundry room, and access to the master bedroom from the bathroom inaccessible to children in care. LPA observed the garage door from the backyard closed and locked with the key hanging from the keyhole. Per licensee, the garage is inaccessible, and children are not strong enough to turn the key and open the door. LPA observed a gate located on the side of the house, making a small portion of the backyard inaccessible to children in care. LPA observed that area where the hot tub was previously located on facility sketch is now replaced with outdoor toys. Per licensee, there are no bodies of water on the premises.

LPA did not observe any barriers making the living room accessible to children in care. Per Licensee, children are dropped off and picked up from the front door and are walked through the living room to access the
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE: DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/19/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 09/19/2024 04:00 PM - It Cannot Be Edited


Created By: Jonnisha Culbert On 09/19/2024 at 01:12 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ANTONINI FAMILY CHILD CARE
FACILITY NUMBER: 198011765

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2024

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
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Based on interview and record review, the licensee did not comply with the section cited above in 1out of total 3 persons did not have a current mandated reporter training certificate which poses a potential safety risk to persons in care.
POC Due Date: 10/03/2024
Plan of Correction
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Per licensee, assistant 1 will complete renewal of mandated reporter training by Sunday and they will email certificate to LPA before plan of correction date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Valarie Cook
LICENSING EVALUATOR NAME:Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:
DATE: 09/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/19/2024


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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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ANTONINI FAMILY CHILD CARE
FACILITY NUMBER: 198011765
VISIT DATE: 09/19/2024
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designated childcare areas. The Licensee was advised that off-limit areas must be made inaccessible during operating hours. LPA requested a new facility sketch with all facility updates.

Areas used by children were inspected for safety, comfort, heating, cleanliness, and telephone service. LPA did not observe any wall heaters or fireplaces in the facility. The facility has central air and heating. Detergents, cleaning compounds and medicines were made inaccessible to children in care. Per Licensee, poisons are kept in the garage. Licensee was advised that if any poisons are purchased, it is required to be in a location that is locked and inaccessible.

The facility has firearms and ammunition on the premises that are properly stored per Title 22 regulations. The Licensee has a dog and cat that are kept in one of the off-limit bedrooms. LPA observed age-appropriate toys and napping equipment for children. LPA observed electrical outlet covers installed in the childcare areas. LPA observed the required fire extinguisher (2A-10BC) that was purchased on 06/24/2024 and is fully charged. Licensee was reminded to have the fire extinguisher serviced yearly. Per Licensee, the smoke detector and carbon monoxide detector are attached to the ADT system that is checked by the Fire Department annually. In addition to ADT system, LPA observed an operable smoke and carbon monoxide detector located in napping room.

Licensee stated that she provides meals and snacks to the children via food program. Per Licensee, children do not bring food from home. Licensee was reminded that food brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.

The following documents were posted in a prominent, publicly accessible area: Facility License, Notification of Parents' Rights (PUB 394), Earthquake Preparedness (LIC 9148), and Emergency Disaster Plan (LIC 610A). The Licensee had verification of disaster and fire drills available for review. The last drill was conducted on 06/11/2024. The Licensee also has a current Facility Roster (LIC 9040) available for review.



Children and personnel files were reviewed for completeness. LPA reviewed children files and observed that children files were complete. LPA reviewed personnel files. Licensee has the required mandated reporter training with a completion date of 09/29/2022, American heart Association Heartsaver Pediatric First Aid/CPR
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ANTONINI FAMILY CHILD CARE
FACILITY NUMBER: 198011765
VISIT DATE: 09/19/2024
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AED completed on 02/26/2023 and required immunizations with flu declination. LPA observed assistant 1 and assistant 2 file and observed that mandated reporter training and Pediatric Firstaid/CPR AED expired for assistant 1. This poses a potential health and safety risk for children in care. LPA observed that assistant 2 had basic life support CPR. Per licensee, assistant 2 is not life alone with the children.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/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 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/.

Licensee was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ANTONINI FAMILY CHILD CARE
FACILITY NUMBER: 198011765
VISIT DATE: 09/19/2024
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(R&Rs) throughout California.

During the exit interview, Marla Antonini, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

One Type B deficiency is being cited based on LPA’s record review and interview in accordance with the California Code of Regulations, Title 22, see LIC 809D. A Violation regarding Operation of a Family Child Care Home and a B violation regarding fire extinguisher.

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

Exit interview conducted and report was reviewed with the licensee, Marla Antonini.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jonnisha Culbert
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC809 (FAS) - (06/04)
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