198018517-3-14-2025-54-CC-RDEO-DERTC5-20250314143611

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198018517
Report Date: 03/14/2025
Date Signed: 03/14/2025 02:36:50 PM

Document Has Been Signed on 03/14/2025 02:36 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:	PATTERSON FAMILY CHILD CARE		FACILITY NUMBER:	198018517
ADMINISTRATOR/ DIRECTOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 13	CENSUS: 9	DATE:	03/14/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Licensee - Elena Patterson		TIME VISIT/ INSPECTION COMPLETED:	03:00 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 Analyst (LPA) R. Derraco conducted an unannounced annual inspection to the above facility on 03/14/25. LPA arrived at the facility at 09:15 AM and met with licensee, Elena Patterson, who guided analyst on a tour. Also present during this inspection was assistant S2. Per Licensee, there are 13 children that are currently enrolled. There were 9 children present upon arrival; Of the 9 children present, 6 children are infants. LPA advised licensee that a Type A citation under California Code of Regulation (CCR) section 102416.5(b)(1) and 102416.5(c) will be issued. S2 was observed to have background clearance however she is currently not associated to the facility roster. LPA advised licensee that a citation under Health and Safety Code (HSC) section 1596.871(c)(1)(A) will be issued. Individuals who reside in the home were noted and discussed. 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. This is a one-story home which consists of 3 bedrooms, 3 bathrooms, kitchen/dining room, living room, a detached garage, front yard and backyard (fenced). Per licensee, the detached garage is part of an Additional Dwelling Unit (ADU) that has been certified for the City of Long Beach. Licensee was unable to provide any documentation regarding the ADU during the inspection. The off limit areas include the garage and the front yard The main care are is located in the living room. LPA observed two couches, a diapering station a wall mounted television, and age appropriate toys. A fireplace was observed to be covered and locked with a fireplace cover. Per licensee, she provides food for children in care. The kitchen was observed to have locks (page 1 of 4)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 11

Document Has Been Signed on 03/14/2025 02:36 PM - It Cannot Be Edited

Created By: Randy Derraco On 03/14/2025 at 01:04 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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type A

Section Cited

CCR

102416.5(b)(1)

Staffing Ratio and Capacity

(b) For a Small Family Child Care Home, the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following: (1) Four infants; or This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee provided care for 6 infants which poses and immediate Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/17/2025
	Plan of Correction
1 2 3 4	Licensee states she will disenroll 2-3 families OR arrange her drop off scheduled to insure she is within capacity requirements. POC visit follow up

Type A

Section Cited

CCR

102416.5(c)

Staffing Ratio and Capacity

(c) The total licensed capacity for a Small Family Child Care Home shall not exceed eight children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee exceeded 8 children in care which poses an immediate Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/17/2025
	Plan of Correction
1 2 3 4	Licensee states she will disenroll 2-3 families OR arrange her drop off scheduled to insure she is within capacity requirements. Licensee states she will consider applying for a large capacity license POC visit follow up.

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 2 of 11

Document Has Been Signed on 03/14/2025 02:36 PM - It Cannot Be Edited

Created By: Randy Derraco On 03/14/2025 at 01:04 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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)

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: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interview, the licensee had knives and cleaning supplies accesible in the kitchen area which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC Visit

Type B

Section Cited

CCR

102417(g)(1)

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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did have a fire extinguisher that meet standards established by the State Fire Marshall which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC Visit

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 3 of 11

Document Has Been Signed on 03/14/2025 02:36 PM - It Cannot Be Edited

Created By: Randy Derraco On 03/14/2025 at 01:04 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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.871(c)(1)(A)

Administration of Child Day Care Licensing

Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, S2 was not associated to the facility roster which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC Visit

Type B

Section Cited

CCR

102416(c)

Personnel Requirements

(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not Pediatric CPR and Pediatirc First Aid training that is certified with EMSA which poses a potential Health, safety and/or personal rights risk to persons in care..
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC Visit

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 4 of 11

Document Has Been Signed on 03/14/2025 02:36 PM - It Cannot Be Edited

Created By: Randy Derraco On 03/14/2025 at 01:04 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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102418(g)

Immunizations

(g) The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not maintain immuzation records for C7 which poses and potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC Visit

Type B

Section Cited

CCR

102419(d)

Admission Procedures and Parental and Authorized Representative's Rights

(d) At the time of acceptance of each child into care, the licensee shall provide the child's parent or authorized representative with a copy of the notice Family Child Care Home Notification of Parent's Rights, LIC 995A (8/06), the Caregiver Background Check Process, LIC 995E (6/05), and the Family child Care Consumer Awareness Information, LIC 9212 (10/05). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not provide C7's parent's with a Notification of Parent's Rights - LIC 995A which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC Visit

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 5 of 11

Document Has Been Signed on 03/14/2025 02:36 PM - It Cannot Be Edited

Created By: Randy Derraco On 03/14/2025 at 01:04 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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102421(b)

Child's Records

(b) The licensee shall maintain, in each child's record, a copy of the emergency information card as required in Section 102417(g)(7). This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, interview and record review, the licensee did not maintain a copy of the emergency information card for C7 which poses a potential Health, safety and/or personal rights risk to persons in care.
	POC Due Date: 03/24/2025
	Plan of Correction
1 2 3 4	POC visit

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Randy Derraco

LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 6 of 11

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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
	VISIT DATE: 03/14/2025

NARRATIVE

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beneath the kitchen sink. LPA observed a knife block and cleaning supplies on top of the kitchen counter. LPA advised licensee that a citation under CCR section 102417(g) will be issued. The dining area was observed with a dining table, dining chairs, and 4 Cosco high chair feeding tables. Bedroom 1 was observed with a bed, bedroom furniture and 2 pack n play playpens. Bedroom 2 was observed with a couch, computer desk, and two more pack n play play pens. The master bedroom was observed with a bed, bedroom furniture and two more pack n play playpens. All bathrooms in the home are designated for use by children in care. All bathrooms were observed to be clean with an operable sink, faucet and toilet. The outdoor play area is located in the backyard. LPA observed additional age appropriate toys, outdoor play equipment and patio furniture. Perimeter fencing was observed in the backyard and is used to separate the play area from the space designated for the ADU. LPAs did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted.

All areas identified on the facility sketch that are accessible for children to use were inspected for safety,
comfort, and cleanliness. There is telephone service via a cellphone that is used and the cellphone stays at the facility during operation hours. Per Licensee, the home is equipped with central heating and air conditioning. The licensee understands that storage areas for poisons must be locked, not just inaccessible. LPA observed that the home is equipped with a 1A-10BC Fire extinguisher. LPA advised licensee that a citation under 102417(g)(1) will be issued. Smoke and carbon monoxide detectors were tested and are operable. No bodies of water were observed in the back yard play area. LPA observed 2 pet dogs and two pet cats on the premises. Licensee states that there are no firearms stored in the home. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

The licensee has completed training on preventive health practices including Pediatric First Aid and CPR, however the CPR and First aid training certificate is not EMSA certified. LPA advised licensee that a citation under CCR section 102416(c) will be issued. LPA observed that the Licensee has proof of the Mandated Reporter AB 1207 compliant Child Care Training Certificate on file. File review was observed to have proper mandated immunization records. Children’s records were reviewed. LPA observed that C7 does not have a file. Per licensee, C7 has been attending day care for approximately 2 months. LPA advised licensee that citations under CCR section 102418(g), 102419(d), and 102421(b) will be issued. A current children’s roster was available for review.
(page 2 of 4)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 9 of 11

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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
	VISIT DATE: 03/14/2025

NARRATIVE

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LPA advised the licensee to access forms, regulations and quarterly updates online at: www.cdss.ca.gov.

The following deficiencies listed on the attached LIC 809 (deficiency page) 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 & safety.

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 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, the licensee confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA R. Derraco informed licensee Elena Patterson that this report dated 03/14/25 document(s) two Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
(page 3 of 4)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 10 of 11

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: PATTERSON FAMILY CHILD CARE	FACILITY NUMBER: 198018517
	VISIT DATE: 03/14/2025

NARRATIVE

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Also, LPA R. Derraco informed the licensee Elena Patterson to provide a copy of this licensing report dated 03/14/25 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

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

Exit interview conducted and report reviewed with licensee, Elena Patterson.

(page 4 of 4)

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025

LIC809 (FAS) - (06/04)

Page: 11 of 11