198016984-7-17-2024-54-CC-JESA-D79VR9-20240717163934

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198016984
Report Date: 07/17/2024
Date Signed: 07/17/2024 04:40:21 PM

Document Has Been Signed on 07/17/2024 04:40 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	ENGBERG FAMILY CHILD CARE		FACILITY NUMBER:	198016984
ADMINISTRATOR/ DIRECTOR:	ENGBERG, TONI		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 233-9872
CITY:	LAKEWOOD	STATE: CA	ZIP CODE:	90712
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 11	DATE:	07/17/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:50 PM
MET WITH:	Staff Jacqueline Valenzuela		TIME VISIT/ INSPECTION COMPLETED:	04:50 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 Analysts (LPAs) Jonnisha Culbert and Jeanette Estrada conducted an unannounced inspection at the facility noted above and initially met with staff, Jacqueline Valenzuela. LPAs were advised that licensee was not present in the home. Licensee arrived at approximately 3:15PM. Staff and Licensee were advised of the purpose of the visit. The purpose of the inspection was to conduct a annual/random inspection. The operating hours of the facility is Monday through Friday from 7 AM to 5:30 PM. Ages care is provided to are 0-12 years old. Entrance Checklist (LIC 126) was provided to the staff upon arrival. Individuals residing in the home were discussed and noted. At the time of the inspection, there were two (2) Assistants, and eleven (11) children were present. All areas that are on limits to children was inspected. This facility is a two-story home that consists of four (4) bedrooms, 4.5 restrooms (powder room), living room, family room, game room, dining room, library room, kitchen, detached garage, fenced backyard, and fenced pool area (located in backyard). Areas that are accessible to children include: one (1) powder room (restroom), living room, family room, game room, dining room, kitchen, and fenced backyard. Per Licensee, the children utilize the fenced backyard for outdoor activity. Areas off-limits to children include: 4 bedrooms, 4 restrooms, library room (located upstairs), detached garage, and fenced pool area located in the backyard. LPAs observed master bedroom door closed, making the off-limit areas inaccessible to children in care. LPAs also observed a child safety gate installed on the bottom of the stairs, making the stairs and upstairs inaccessible to children in care. Licensee was advised that off-limit areas must be made inaccessible during operating hours or while children in care are present. The following documents were posted in a prominent, publicly accessible area: Facility License, Waiver, and Notification of Parents Rights. During today's visit, a Disaster drill log and roster were not available for review. LPAs observed children emergency information on bright wheel app.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ENGBERG FAMILY CHILD CARE	FACILITY NUMBER: 198016984
	VISIT DATE: 07/17/2024

NARRATIVE

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Areas used by children were inspected for safety, comfort, heating, cleanliness and telephone service. The home does not have any wall heaters. LPAs observed a screened fireplace located in the living room. Per assistant, the fireplace is currently inoperable and not used. The home is equipped with central air and heating. Detergents, cleaning compounds, and medicines were made inaccessible to children. Per Licensee, medicines are kept in a locked cupboard in the kitchen and in the off limits master bedroom. Per Licensee, poisons are kept in the off limits locked garage. Licensee was advised that if any poisons are purchased, it is required to be locked with a key or combination lock.

Per Licensee, the home has 4 small dogs, 2 cats, and chickens. LPAs observed a gated area on the side of the house where the chickens are kept, and is inaccessible to children in care. LPAs advised the Licensee that best practice is to keep pets isolated from children in care. LPAs observed a pool that is gated in the backyard. Based on LPAs' observations, the waiver on file for the pool was being followed by the provider. Per Licensee, there are no firearms and/or weapons on the premises. LPAs observed age appropriate toys and napping equipment for children. LPAs also observed electrical outlet covers installed in the child care areas.

LPAs observed the required fire extinguisher (2-A:10-B:C) that is fully charged and was purchased on November 9, 2023. Licensee was reminded to have the fire extinguisher serviced yearly. Carbon monoxide detector was tested and is operable. Due to children sleeping, smoke detector was not checked. First Aid kit and emergency supplies are available and kept in the backyard patio. Licensee was reminded that food that is brought from the child's home shall be labeled with the child’s name and properly stored or refrigerated.

LPA conducted a record review of five (5) children's records and two staff files. All children records were complete. One staff file had an expired mandated reporter training. LPAs advised licensee to have staff update training.
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.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: ENGBERG FAMILY CHILD CARE	FACILITY NUMBER: 198016984
	VISIT DATE: 07/17/2024

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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.
LPAs 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.
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/.
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.
During the exit interview, Toni Engberg, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.
One Type B deficiency is being cited today on page LIC 809D.

A notice of site visit was given and must remain posted for 30 days.
Exit interview conducted and report was reviewed with the licensee Toni Engberg.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Jeanette Estrada
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/17/2024 04:40 PM - It Cannot Be Edited

Created By: Jeanette Estrada On 07/17/2024 at 04:21 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: 07/17/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(9)(A)

Operation of A Family Child Care Home

(g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not limited to: (9) Each family child care home shall have a written disaster plan of action prepared on a form approved by the Department. All children, age and ability permitting, and the provider, the assistant provider, and other members of the household, shall be instructed in their duties under the disaster plan. As their age and ability permit, newly enrolled children shall be informed promptly of their duties as required in the plan. (A) Each family child care home shall conduct fire drills and disaster drills at least once every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, the licensee did not comply with the section cited above. Per Licensee, a disaster drill has not been conducted since 10/2023 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 07/24/2024
	Plan of Correction
1 2 3 4	Licensee will submit proof of disaster drill by due date.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Jeanette Estrada

LICENSING EVALUATOR SIGNATURE:

DATE: 07/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2024

LIC809 (FAS) - (06/04)

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