198016150-4-26-2022-54-CC-ABAY-CDUT5W-20220426142613

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016150
Report Date: 04/26/2022
Date Signed: 04/26/2022 02:33:41 PM

Document Has Been Signed on 04/26/2022 02:33 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	WILLIAMS FAMILY CHILD CARE		FACILITY NUMBER:	198016150
ADMINISTRATOR:	WILLIAMS, ROSALIND		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 462-9958
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90061
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 1	DATE:	04/26/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Rosalind Williams- Licensee		TIME COMPLETED:	02:35 PM

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Licensing Program Analyst (LPA) Alicia Bailey conducted an unannounced random annual (or Required) inspection. LPA met with Licensee Rosalind Williams at 9:30 am who guided this LPA on a tour of the facility. At 9:30am during the inspection LPA Bailey discussed, assessed and noted individuals residing in the home. The facility Entrance Checklist for Family Child Care Homes was given to Licensee Williams . This is a one story home consists of 3 bedrooms and 2 bathroom. Areas used by the children include the day-care room, one (1) restroom, and back yard. Per Licensee Williams and facility sketch , areas off limits to children include: 3 ( three) bedrooms, 1 (one) bathrooms , kitchens and garage .The home was inspected for safety, comfort, cleanliness, telephone service, heating and ventilation, inaccessibility to poisons, detergents, cleaning compounds, medicines, and hazardous items that can pose a danger to children. A parent board with required postings was observed at the entrance of the facility. The Licensee stated there are no other license held at this facility. There were one child during time inspection. Licensee states that there are currently twelve children enrolled. Facility hours of operation Sunday thru Saturday 23 hours 12:00 AM to 11:59 PM.

There are NO weapons, firearms in the facility. LPA Bailey observed there no swimming pool or body of water. At 9:45 am LPA Bailey observed first aid kit, fire extinguisher 2A10BC ( service 03/1/2022) in the kitchen. The smoke detectors, carbon monoxide was tested by LPA are in operable condition.

At 10:05am LPA Bailey tour the children bathroom. LPA Bailey observed children on the bathroom cabinet. LPA Bailey did not observe any hazardous items in the bathroom. At 10:16 am LPA Bailey toured the kitchen the counter tops were clean and free of clutter or standing food. In the kitchen knives was in secure cabinet with. Licensee provides breakfast, lunch and snack. At 10:35 am LPA Bailey observed age appropriate toys and napping equipment on the premises.

At 10:56 am LPA Bailey toured the back yard observed that all areas are adequately fenced and was inspected for hazards.

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198016150
	VISIT DATE: 04/26/2022

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At 11:08 AM LPA Bailey reviewed the Disaster Plan; Emergency Disaster Drill were reviewed. LPA Bailey observed Licensee Williams has not conducted Fire & earthquake drill. LPA Bailey advised licensee Williams to conduct a drill. A current Children roster was viewed and maintained for a period of 3 years, even after children no longer are attending the facility.

Licensee Williams mandated reporter training expired. LPA Bailey advised Licensee Williams to updated mandated reporter. Licensee PED F/A & CPR EXP. 08/14/2023

At 11:23 AM reviewed twelve children file was in compliance.

Licensee Williams was advised that regulation prohibits the smoking of tobacco in a private residence licensed as a family childcare home during the hours of operation. LPA Bailey reviewed with Licensee Williams different item prohibited in FCCH, no baby bouncers, no infant walkers, No Johnny jumpers, no saucer chairs, no trampolines and any other item that falls into that category are not permitted in the facility.

At 11:30 AM Licensee Williams was also reminded that only children eating may be in highchairs and that car seats are utilized only for transportation. Licensee Williams provide transportation

At 12:30pm LPA Bailey conducted the staff interview with Licensee Williams. At 1:00pm LPA Bailey advised Licensee Williams of the following:

To improve the quality and value of the new inspection process, a survey will 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 tools, please send then by email 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.

LPA Bailey reviewed Sudden Infant Death Syndrome (SIDS), Shaken Baby Syndrome, and safe sleep practices with licensee. *Infants should always sleep on their backs, mouths facing up. *

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022

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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: WILLIAMS FAMILY CHILD CARE	FACILITY NUMBER: 198016150
	VISIT DATE: 04/26/2022

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Infant Needs and Services Plan: The written infant needs and services plan shall be updated at least quarterly, or as often as necessary to assure its accuracy. Infant Care: LPA advised the applicant to sleep infants where they can be directly supervised at all time. LPA advised against sleeping infants in a separate room. LPA reviewed SIDs, Never Shake A Baby, and safe sleeping practices. Infants should sleep mouth up, on their backs, free of clutter surrounding their sleeping space. Safe sleep concepts were provided. LPA discussed and provided a copy of PIN 20-24-CCP.

The licensee Williams is not providing Incidental Medial Services currently.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Family Child Care Homes Section 102417. 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

The following was discussed with Licensee Williams Individuals who are 18 years of age or older living in the home must be fingerprint cleared prior to licensure. Individuals within one month of their 18th birthday must be fingerprinted immediately. The existing, immediate $100 per individual Civil Penalty has been increased to an immediate $100 per day Civil Penalty, for a maximum of five days for the first violation and a maximum of 30 days for subsequent violations. If an individual has a clearance with the Department a criminal record clearance may be transferred. LIC 9182 Criminal Background Clearance Transfer Request may be used.

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

Exit interview conducted and report was reviewed with licensee Williams

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Alicia Bailey
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022

LIC809 (FAS) - (06/04)

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