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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198016984
Report Date: 02/15/2023
Date Signed: 02/15/2023 02:26:11 PM

Document Has Been Signed on 02/15/2023 02:26 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:ENGBERG FAMILY CHILD CAREFACILITY NUMBER:
198016984
ADMINISTRATOR:ENGBERG, TONIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(562) 233-9872
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY: 14TOTAL ENROLLED CHILDREN: 21CENSUS: 10DATE:
02/15/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Licensee, Toni EngbergTIME COMPLETED:
02:45 PM
NARRATIVE
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On February 15, 2023 at 9:25 am, Licensing Program Analysts (LPAs) Monique Ayala and Rosaura Valenzuela conducted an unannounced inspection at the facility noted above and met with Licensee, Toni Engberg. The purpose of the inspection was related for a different purpose however, LPAs observed deficiencies while at the facility.

At 9:48 am, LPA Valenzuela observed glass cleaner on the counter of the kitchen while the children were being supervised in the backyard. Licensee got the glass cleaner and placed it in an area inaccessible to children in care.

At 9:54 am, Licensee left the facility to attend an appointment and authorized her personnel to act on her behalf. At 10:26 am, LPA Ayala observed a multi surface cleaning solution left on a table that is under the outdoor patio of the backyard where children were present. The personnel was asked to place the cleaning solution in a place that is inaccessible to children in care. A photograph was taken of the cleaning product on the table in the outdoor patio.

During the inspection, Licensee disclosed that she is in the process of hiring a new staff (S1) and stated that this individual disclosed that they have a DUI on their record. LPA explained the exemption process and found that the fingerprint clearances are currently pending for S1. Confidential interviews during today's inspection revealed that S1 shadowed personnel at the facility yesterday during operating hours.

Information obtained by the Department also revealed that another staff (S2) worked at the facility from February 1, 2023 to February 10, 2023. S2 has since quit and no longer works at the facility however, S2 has pending fingerprint clearances. Licensee stated that she submitted a criminal record transfer request for S2. LPA took photographs of documents available in the personnel record.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE: DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/15/2023
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
CCLD Regional Office, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754
FACILITY NAME: ENGBERG FAMILY CHILD CARE
FACILITY NUMBER: 198016984
VISIT DATE: 02/15/2023
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During the inspection, LPAs observed a staff take an infant into the napping room and could heard an infant crying while left unattended in the napping room. LPA Ayala asked Licensee if the facility normally has the children cry themselves to sleep, which Licensee responded, "he isn't crying, he's loud and is yelling." Licensee then went into the room to get the infant. Licensee then stated, "well now he started to cry because I went in there." LPAs had observed the door to the napping room closed while the infant was left inside the room. LPAs also observed video and audio monitors inside the room where the children nap. Prior to witnessing this incident, Licensee denied that children are forced to nap or forced to remain in the napping area.

As LPA Ayala was documenting this report, LPAs overheard the Licensee tell a child in the napping room to "go stay, lay down." Licensee denied the comments and said that she told the child to put his arms down, and you need to lay still because the child was fidgeting. Licensee continued to deny that children are forced to sleep or stay in the designating napping area.

Deficiencies were cited during today's inspection (refer to deficiency page).

Licensee was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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 was assessed due to this regulation being violated.

A Notice of Site Visit (LIC 9213) was given and must remain posted for 30 days. Acknowledgment of Receipt of Licensing Report (LIC 9224) was also provided.

Exit interview conducted and report was reviewed with Licensee, Toni Engberg.
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Monique Ayala
LICENSING EVALUATOR SIGNATURE:

DATE: 02/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
Document Has Been Signed on 02/15/2023 02:26 PM - It Cannot Be Edited


Created By: Monique Ayala On 02/15/2023 at 12:39 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: ENGBERG FAMILY CHILD CARE
FACILITY NUMBER: 198016984

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/15/2023
Section Cited
CCR
102370(d)(1)

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Criminal Record Clearance 102370(d)(1). All individuals subject to a criminal record review... shall prior to working, residing, or volunteering in a licensed facility (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement is not met as evidenced by:
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Hired personnel will not be present at the facility or assist with providing child care until the required clearances and/or exemptions are granted. Civil penatly for violation was assessed.
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Based on supporting documentation and confidental interviews, staff (S1) and staff (S2) worked at the facility prior to obtaining the required criminal record clearances and/or exemptions, which poses an immediate health and safety risk to persons in care.
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Type A
02/15/2023
Section Cited
CCR102425(e)

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Infant Safe Sleep 102425(e). No infant shall be forced to sleep, to stay awake, or to stay in the designated sleeping area.
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Licensee went into the nap area to get the infant. Licensee was also advised of the violation of the children's personal rights.
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This requirement is not met as evidenced by:
Based on observations and interview, a child was left unattended crying in the nap area and a child was told by Licensee you need to lay down which poses an immediate personal rights risk to persons in care.
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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:Monique Ayala
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 02/15/2023 02:26 PM - It Cannot Be Edited


Created By: Monique Ayala On 02/15/2023 at 12:56 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: ENGBERG FAMILY CHILD CARE
FACILITY NUMBER: 198016984

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/15/2023
Section Cited
CCR
102417(g)(4)

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Operation of a Family Child Care Home 102417(g)(4). Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children.
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Licensee and Licensee's Assistant had immediately removed the clearning products and placed them in an area that is inaccessible to children in care. Licensee will provide training to all staff on the violation to prevent cleaning compounds being accessible to children.
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This requirement is not met as evidenced by:
LPAs observed a cleaning product accessible to children in care on top of the kitchen counter, and on top of a table in the outdoor patio while children were present, which poses a potential risk to persons in care.
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Licensee will submit any training material that was presented to staff and a sign-in sheet for attendees to LPA via e-mail by 03/15/2023.

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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:Monique Ayala
LICENSING EVALUATOR SIGNATURE:
DATE: 02/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/15/2023


LIC809 (FAS) - (06/04)
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