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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198017322
Report Date: 06/16/2022
Date Signed: 06/16/2022 04:04:02 PM

Document Has Been Signed on 06/16/2022 04:04 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME:THOMPSON FAMILY CHILD CAREFACILITY NUMBER:
198017322
ADMINISTRATOR:THOMPSON, MARIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(626) 483-8028
CITY:SIERRA MADRESTATE: CAZIP CODE:
91024
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 2DATE:
06/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
03:46 PM
MET WITH:Licensee, Maria ThompsonTIME COMPLETED:
04:00 PM
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This report/inspection was originally provided/conducted on 6/8/22 but was lost due to a consistency check.

Licensing Program Analyst (LPA), Bardo Baluyot conducted an unannounced Required Annual Inspections today and met with Licensee, Maria Thompson who guided LPA on tour of the facility. LPA conducted a COVID risk self-assessment upon entry. Licensee’s sister/assistant was also present during the inspection. LPA observed 2 children present, one being the Assistant’s granddaughter.

There are 2 bedrooms, 2 bathrooms, living room and dining area. Children use the restroom which is next to the kitchen, living and dining room area. There is a fireplace in the living room which is made inaccessible via child safety lock. Per Licensee, gas has been shut off permanently and fireplace is inoperable. The backyard is also used for outdoor play. Licensee has one dog. All areas on the facility sketch were inspected. Per Licensee, there are no firearms in the home.

There is a 2A 10BC fire extinguisher located in the laundry room adjacent to the kitchen has service tag of 7/12/21. Smoke and carbon monoxide detector are in operable condition. Home has central air and heat. Kitchen knives and other sharp utensil are kept out of reach via gates. Cleaning products are kept out of reach and is kept inaccessible to children via child safety locks. Restroom used by children are free of medications, toiletries and shampoos.

No smoking, 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. Effective January 1, 2010, licensees of family childcare homes are required to ensure that at least on staff member with current training in pediatric first aid and pediatric CPR. First Aid and CPR. Current immunization requirements for licensee and staff were discussed. There are no children with IMS services.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE: DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/16/2022
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: THOMPSON FAMILY CHILD CARE
FACILITY NUMBER: 198017322
VISIT DATE: 06/16/2022
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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-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.

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 was reminded that all adults 18 and over, 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 Child Care Center. 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.

LPA reviewed children’s records. Roster was current and records were complete.

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 conducted and report was reviewed with the Licensee Maria Thompson.

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 them 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/process.

SUPERVISORS NAME: Ana Chico
LICENSING EVALUATOR NAME: Bardo Baluyot
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
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