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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016150
Report Date: 02/24/2023
Date Signed: 02/24/2023 01:03:30 PM

Document Has Been Signed on 02/24/2023 01:03 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME:WILLIAMS FAMILY CHILD CAREFACILITY NUMBER:
198016150
ADMINISTRATOR:WILLIAMS, ROSALINDFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(310) 462-9958
CITY:LOS ANGELESSTATE: CAZIP CODE:
90061
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 5DATE:
02/24/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:ROSALIND WILLIAMSTIME COMPLETED:
01:40 PM
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25		On 02/24/2023 at 9:15 AM, Licensing Program Analyst (LPA) Franchesca White and Katrina Chicote conducted an Unannounced Required – 1 Year inspection to the above facility. Upon arrival, LPAS disclosed the purpose of the inspection and met with Licensee, Rosalind Williams, who granted entry to facility. Adult in the home was discussed and has criminal record clearance. There were initially four preschoolers upon arrival with another arriving later, totaling five preschoolers present during today’s inspection. Licensee states that there are currently ten children enrolled. The children's roster was reviewed and is current. LPA observed required postings at time of inspection. Disaster drill log was also available during today’s inspection, last disaster drill conducted on 12/17/2022.

This is a single-story home which consists of three bedrooms and two bathrooms, Kitchen, Living Room, Dining Room, and covered porch. Per Licensee, areas used by the children include covered porch (located in the front of the home),Living Room with Bathroom 1 adjacent to the back sliding door. Per Licensee, areas off limits to children and parents include: Bedrooms 1,2,3, Bathroom 2, and Kitchen.

At 9:25 AM, LPAs observed Living Room to have shelves with board games, books, and other age appropriate toys, free of loose and sharp parts available for children at time of inspection. There were cots for napping stored behind the cubbies, and individual boxes for the children's blankets. Per Licensee, she provides and maintains the cleanliness of the sheets and blankets weekly.

All areas identified on the facility sketch as accessible to children were inspected to ensure that they are clean and orderly with ventilation and heating for the safety of the children. There is a working telephone maintained in the home.
Report continues- Page 1 of 4
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE: DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/24/2023
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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198016150
VISIT DATE: 02/24/2023
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LPA observed electrical cover outlets all through the home. LPA observed Living Room to have four flat screen televisions. Per Licensee, Isolation area of sick children will be in an unoccupied area of the Living Room. At 9:30 AM, LPA observed Bathroom 1 to have operable toilet and sink, adequate hand washing and toileting supplies, contains a changing table, a wall mount shelf for pull-ups, and three portable training potties. Area observed to be well maintained, floors clean, and free of debris. Area observed for safety and sanitation at time of inspection. Detergents, cleaning compounds, medications, and other items which can pose a danger to children are inaccessible. Per Licensee, cleaning items are stored in off limits areas. The Licensee states that there are no poisons in the home. The Licensee does understand that poison must be locked with a key or combination lock.

At 9:40 a.m. LPAS observed a sliding door of the Living Room leading to the backyard. Per Licensee, the backyard has not been used for an extended period of time. At time of inspection, yard was observed to be fully fenced with concrete flooring, a multi-leveled play structure with miscellaneous toys covering a portion of the yard.

At 9:45 AM, LPA observed the valve on the required 2A 10BC fire extinguisher (located in the kitchen) indicates fully charged with proof of service tag on 03/2022. At 9:48AM, smoke detector in Living Room tested and observed to be in operable condition at time of inspection. At 9:50 a.m. Carbon Monoxide detector (located in Bedroom 1) was tested and observed to be in operable condition at time of inspection. LPA observed First Aid kit available in the living room on the wall adjacent to the kitchen. The Licensee has current Pediatric First Aid and CPR valid until 08/14/2023. Proof of immunization against influenza, pertussis, and measles has expired and must be updated. The Licensee has also taken the AB1207 Mandated Reporter Training in 2018, LPA discussed and provided information for this training with Licensee.


Report Continues - Page 2 of 4
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
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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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198016150
VISIT DATE: 02/24/2023
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Per Licensee, there are no weapons, firearms in the home and there are no bodies of water around the premises. LPA observation did not see any bodies of water around the premises or weapons/firearms at time of inspection.

The following were discussed:
Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for 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

Licensee (or facility representative) was reminded that all adults 18 and over living or working in the home, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

NO smoking, NO infant walkers, NO Johnny jumpers, NO saucer chairs, NO incline sleepers and any other item that falls into that category are permitted in the facility.



The Licensee was advised that inaccessibility of hazards must be constantly reassessed depending on the children in care.

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

AB 1207: Beginning on January 1, 2018, this law requires all licensed providers, applicants, directors and employees to complete training as specified on their mandated reporter duties and to renew their training every
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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198016150
VISIT DATE: 02/24/2023
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two years. Volunteers are encouraged but not required to take the training. Website: http://www.mandatedreporterca.com/

Senate Bill 792: this bill, commencing September 1, 2016, prohibits a person from being employed or volunteering at a child care facility or family day care if he or she has not been immunized against influenza, pertussis and measles. LPA discussed the influenza waiver during the visit.


Based of this information, the following deficiencies on the attached LIC 809 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. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with the Licensee, Rosalind Williams.

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SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/24/2023 01:03 PM - It Cannot Be Edited


Created By: Franchesca White On 02/24/2023 at 11:50 AM
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: WILLIAMS FAMILY CHILD CARE
FACILITY NUMBER: 198016150

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/24/2023

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 2 out of 2 staff files, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/10/2023
Plan of Correction
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Licensee will send her current training documentation by due 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:Franchesca White
LICENSING EVALUATOR SIGNATURE:
DATE: 02/24/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/24/2023


LIC809 (FAS) - (06/04)
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