198011778-7-14-2021-33-CC-LGOZ-C4WRNM-20210714131035

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198011778
Report Date: 07/14/2021
Date Signed: 07/14/2021 01:10:53 PM

Document Has Been Signed on 07/14/2021 01:10 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, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	KING FAMILY CHILD CARE		FACILITY NUMBER:	198011778
ADMINISTRATOR:	KING, GABRIELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 264-8862
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90022
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 0	CENSUS: 3	DATE:	07/14/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:41 AM
MET WITH:	Gabriela King		TIME COMPLETED:	01:22 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	Licensing Program Analyst (LPA) Lissete Gonzalez conducted an unannounced annual inspection to the above facility on 07/14/2021. LPA met with Licensee, Gabriela King, who guided analyst on a tour of the facility. Also present was Licensee’s husband/assistant, Sergio Ureta. Per Licensee, there are 11 children currently enrolled. A current children’s roster was available for review. There were 3 children present. This is a one story home which consists of 3 bedrooms, 2 bathrooms, kitchen, living room, dining room, front, backyard, and converted garage/activity room. The children have access to 2 bathrooms, living room, dining room, breakfast nook, 2 bedrooms, front and back yard, and activity room/converted garage with bathroom (licensee was reminded NO EATING OR SLEEPING in the activity room). Children eat in the kitchen under supervision. Per licensee, areas off limits to children and parents include: 1 bedroom. LPA toured all areas used by children during this visit. Licensee provides breakfast, lunch, and snacks. Individuals who reside in the home were noted and discussed. All adults present in the home have obtained a criminal record clearance. Licensee states that there are no firearms in the home. All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. There is telephone service via a cell phone that is used and the cellphone stays at the facility during operation hours. There is ventilation and heating (central). Safe toys play equipment and materials were observed. Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. There are inaccessible poisons stored in a shed located in the backyard that is locked with a key. The restrooms that children use were observed to be safe and sanitary. REPORT CONTINUES ON NEXT PAGE: 1 OF 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

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

FACILITY NAME: KING FAMILY CHILD CARE	FACILITY NUMBER: 198011778
	VISIT DATE: 07/14/2021

NARRATIVE

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The valve on the required 2A 10BC fire extinguisher indicates fully charged and was serviced on 4/16/2021. Smoke and carbon monoxide detectors were tested and are operable.

Licensee states that she is not currently caring for infants. Appropriate sleeping arrangements and cots were discussed. LPA advised Licensee that cribs or play yards cannot hinder the entrance or exit from the sleeping space, mattresses shall be firm and covered with a fitted sheet that overlaps the underside it cannot be dislodged. Infant cribs must be free of loose articles and objects. Objects cannot be hung above or attached to the side of the crib. LPA advised the Licensee that infants cannot be swaddled, shall be placed on their backs for sleeping and shall be supervised. Infants shall be checked on every 15 minutes and the time of each 15-minute check shall be documented with child’s name and date. The LIC 9227 Individual Infant Sleeping Plan shall be completed for each infant.

Currently, children are using the front yard and back yard for outdoor play time. The outdoor play areas were observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA did not observe any objects that can pose a danger to children on the outdoor yard. The licensee states that supervision is always provided. LPA observed an inaccessible hot tub/spa located in the back yard. LPA observed a fence measuring five feet with a self-latching door that swings out. In addition, the hot tub/spa had a tight fitting cover at the time of this visit.

The licensee is observed to be operating within the license capacity limitations. LPA did not observe any children left in parked vehicles. Car seats shall only be used for transportation. LPA did not observe any children sleeping in car seats.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 11/2021. Assistant, Sergio Ureta’s Pediatric First Aid and CPR expires on 11/2021. There are first aid supplies available. LPA advised that if a child shows signs of illness he/she/they shall be separated from other children.

Children’s records were reviewed, including emergency information and were observed to be complete. The licensee has proof of immunization against influenza, pertussis, and measles. REPORT CONTINUES ON NEXT PAGE: 2 OF 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

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

FACILITY NAME: KING FAMILY CHILD CARE	FACILITY NUMBER: 198011778
	VISIT DATE: 07/14/2021

NARRATIVE

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LPA observed that the Licensee and assistant have a current Mandated Reporter AB 1207 Compliant Child Care Training Certificate on file.

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 documented was conducted on 7/07/2021.

There is one dog on the premises. The dog was not present in the home at the time of the visit. Per Licensee, the dog is kept in maintained in the off limits bedroom. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs, Trampolines and/or any other item that fall into these categories are not permitted in a family child care facility. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

LPA provided the licensee with a copy of A Child Care Provider’s Guide to Safe Sleep, by American Academy of Pediatrics. LPA also consulted and explained Child Abuse Reporting, Never Shake a Baby, and Safe Sleeping practices.

Incidental Medical Services (IMS):
This facility does not provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Section 102417. 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.

LPA advised the licensee to access forms, regulations and quarterly updates online at: www.ccld.ca.gov. LPA also discussed the Provider Information Notices (PINS) on Safe Sleep Awareness: PIN 19-02-CCP, COVID FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: KING FAMILY CHILD CARE	FACILITY NUMBER: 198011778
	VISIT DATE: 07/14/2021

NARRATIVE

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FAQ - PIN 20-11-CCP, Required Lead Testing: PIN 20-01 CCP Effects of Lead Exposure, and Guardian User Account Access - PIN 20-20-CCLD.

No deficiencies cited during today’s visit.

Exit interview was conducted with Licensee, Gabriela King, including, but not limited to Appeal Procedures, Site Visit and Initial Appeal Rights.

The Notice of Site Visit (LIC 9213) – must remain posted for 30 days during the hours of operation after each site visit made by a licensing representative. Failure to maintain posting as required will result in a civil penalty of $100.00.

REPORT CONTINUES ON NEXT PAGE: 4 OF 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Lissete Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2021

LIC809 (FAS) - (06/04)

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