198013467-9-27-2024-33-CC-VMGA-D9HULQ-20240927154108

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198013467
Report Date: 09/27/2024
Date Signed: 09/27/2024 03:41:18 PM

Document Has Been Signed on 09/27/2024 03:41 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:	KAWAI FAMILY CHILD CARE		FACILITY NUMBER:	198013467
ADMINISTRATOR/ DIRECTOR:	KAWAI, NANCY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(323) 728-5437
CITY:	MONTEBELLO	STATE: CA	ZIP CODE:	90640
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 18	CENSUS: 4	DATE:	09/27/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:40 PM
MET WITH:	Nancy Kawai		TIME VISIT/ INSPECTION COMPLETED:	03:55 PM

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Licensing Program Analyst (LPA) Veronica Martinez Garza conducted an unannounced Annual/Random inspection at the above facility on 09/27/24 at 01:40 pm. LPA met with Diana Kawai, licensee’s mother/assistant who guided LPA on a tour of the facility. Per licensee’s mother, Nancy Kawai (licensee) had a dental appointment; however, the licensee was on her way to the facility. There were 04 children present during this inspection. Also present during this inspection was the licensee’s second assistant Guadalupe Leon. Per licensee, 18 children are enrolled. Operation hours are Monday through Friday 07:00am – 06:00pm. Licensee arrived at approximately 01:47 pm and assisted LPA with the inspection.

This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen, dining room, living room, laundry room, garage (activity room) and front yard (unfenced) and back yard (fenced). Areas accessible to children include living room, dining room, kitchen, 1 bathroom, back yard, and garage. Areas off limits to children and parents include 3 bedrooms, 1 bathroom, and front yard. Licensee states, there are no pets on the premises. Per licensee, family members residing in the home are 2 adults and 1 minor. All individuals present in the home have obtained a criminal record clearance or exemption prior to working, residing, or volunteering in a licensed home and are identified on the attached LIC811.

LPA toured all areas identified on the facility sketch used by children during this visit and were inspected for safety, comfort, and cleanliness. Tour began in the living room where LPA observed safe toys, play equipment and materials for children. LPA also observed observed children napping on cots in the living room and dining room. Adjacent to the living is the dining room and kitchen. LPA also observed (1) child napping in a play pen. LPA observed that the play pen is free from loose articles and objects. There are no objects hanging above or attached to the side of the play pen. LPA observed that the play pen does not hinder the entrance or exit to and from the space they are sleeping in. Mattresses were observed to be firm and covered with a fitted sheet that is appropriate to the mattress size. Per licensee, the kitchen is accessible to children. LPA observed the kitchen cabinets have child proof locks. The children’s bathroom is in the hallway between the bedrooms. The children’s bathroom was observed to be in safe and in sanitary conditions. There’s also a first aid kit readily available.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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: KAWAI FAMILY CHILD CARE	FACILITY NUMBER: 198013467
	VISIT DATE: 09/27/2024

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LPA observed the following required posted documentation in the dining room of the facility: Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. LPA reviewed facility records LIC 610- Emergency Disaster Plan and Disaster drill log. 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 conducted on 09/03/24. Children’s roster was available during this inspection.

LPA did not observe any pools, spas, hot tubs, fishponds, or similar bodies of water during the inspection.

Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary. **Rooms that are off-limits need to be made inaccessible during operating hours**

Per licensee, food is provided to children. Licensee was advised that if food is brought from the children’s homes, all containers must be labeled with the child’s name and properly stored or refrigerated. There is telephone service via a landline. There is ventilation and heating.

Detergents, cleaning compounds, medications, and other items which could pose a danger to children were observed to be inaccessible to children. The licensee states poisons are locked. Per licensee, there are no firearms or weapons stored in the home.

At 01:45 pm. smoke and carbon monoxide detectors were observed to be operable. The valve on the required 2 A10 BC fire extinguisher indicates fully charged and was serviced on 04/23/24, per the attached service tag. Per State Fire Marshall standards, fire extinguishers shall be serviced annually.

The isolation area for sick children waiting to be picked up is in any area accessible to children that is not being used with supervision.

Smoking is prohibited in a licensed Family Child Care Home. Per licensee, no one smokes in the home.

Currently children are using the back yard for outdoor play. LPA observed the backyard has adequate shade, age-appropriate toys, and equipment. LPA also observed that the garage is converted into an activity room. LPA observed safe toys, play equipment and materials for children. LPA did not observe any objects that could be hazardous to children in care. LPA advised licensee to check with the American Standard Testing Materials for Playground Guidelines and/or to use the manufactures recommendations for the playground equipment in efforts to be more in line with safety guidelines. Licensee understands that children should be supervised at all times.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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: KAWAI FAMILY CHILD CARE	FACILITY NUMBER: 198013467
	VISIT DATE: 09/27/2024

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Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunization's Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, and LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form (0-12 months, and documentation of 15-minute Infant Sleep Check (0-24 months). LPA observed all children’s files are complete.

Licensee and assistants records were reviewed for approved Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement Acknowledging Requirement to Report Child Abuse and current Mandated Reporter Training Certificate. Licensee’s Mandated Reporter Training AB1207 expires on 04/17/25. Licensee’s Pediatric CPR/FA expires on 04/27/27.

AB1207 Mandated Child Abuse Reporting – On or before March 30, 2018, any person who works in a child care facility shall complete the training and renew the training every 2 years. Website provided: https://www.mandatedreporterca.com/training/child-care-providers

The licensee is operating within proper capacity and ratios. LPA observed licensee to be present at the home and providing adequate care and supervision.

Licensee does care for infants. 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. No infant walkers, No baby bouncers, No Johnny jumpers, No exersaucers and any other item that falls into that category.

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: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

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: KAWAI FAMILY CHILD CARE	FACILITY NUMBER: 198013467
	VISIT DATE: 09/27/2024

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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.

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 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.

Licensee Nancy Kawai confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

At this time, the facility is in compliance with California Title 22 Regulations. Therefore, there are no deficiencies being issued today.

Exit interview conducted and report was reviewed with the licensee Nancy Kawai.

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SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Veronica Martinez-Garza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2024

LIC809 (FAS) - (06/04)

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