198019864-9-12-2022-54-CC-SSAZ-CJ7Q3Y-20220912114930

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198019864
Report Date: 09/12/2022
Date Signed: 09/12/2022 11:49:43 AM

Document Has Been Signed on 09/12/2022 11:49 AM - 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:	WILLIAMS-GREER FAMILY CHILD CARE		FACILITY NUMBER:	198019864
ADMINISTRATOR:	KOLISHA WILLIAMS		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(310) 978-5176
CITY:	CARSON	STATE: CA	ZIP CODE:	90746
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 7	DATE:	09/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Kolisha Williams-Greer, Licensee		TIME COMPLETED:	12:10 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 (LPA) Susann Sanchez conducted an unannounced annual required inspection at the above facility on 09/12/22 at 9:25 AM. There was 3 children, 4 infants, 1 staff, and the licensee present when LPA arrived. Licensee Kolisha Williams-Greer give LPA a tour of the facility. Facility capacity is in compliance for a Largel Family Child Care Home. Hours of operation are Mon-Sun 12:00 AM - 11:58PM. A child left at 10:19am. This is a two-story home which consists of 4 bedrooms, 2 bathrooms, kitchen, dining room, living room, family room, and attached garage, backyard and front yard. Areas designated for childcare use: 1 bathroom in the hallway by the kitchen, living room, dining room, family room and backyard. LPA observed that there is a fireplace in the family room and is barricaded. Areas off limits to children and parents include per licensee: Upper level, kitchen, attached garage, downstair bedroom, and front yard. The licensee provides food for children in care. Licensee was reminded if children bring food from home it must be labeled with the child’s name and properly stored or refrigerated. Individuals residing in the home have been discussed and noted. All adults present in the home have obtained a criminal record clearance or exemption. LPA observed that licensee is implementing COVID-19 precautions and procedures All areas identified on the facility sketch that are accessible for children to use were inspected for safety, comfort, and cleanliness. The following was observed and reviewed during this inspection: LPA reviewed required posted documentation for Facility License, Publication (PUB) 394- Notification of Parent Rights and Licensing Form (LIC) 9148- Earthquake Preparedness form. Facility records were reviewed for LIC 9040- Facility Roster, LIC 610- Facility Disaster Plan and Disaster drill log, last drill conducted on 8/19/22.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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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Document Has Been Signed on 09/12/2022 11:49 AM - It Cannot Be Edited

Created By: Susann Sanchez On 09/12/2022 at 11:17 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-GREER FAMILY CHILD CARE	FACILITY NUMBER: 198019864
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/12/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

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 interview and record review, the licensee did not comply with the section cited above. During record review, LPA did not observe a current CPR & 1st Aid certificate. Per Licensee, she did not realized certificate had just expires and stated she will renew. This poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 10/12/2022
	Plan of Correction
1 2 3 4	Per Licensee will renew CPR & 1st Aid certificate and submit proof via email by POC due date of 10/12/2022.

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:

Susann Sanchez

LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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: WILLIAMS-GREER FAMILY CHILD CARE	FACILITY NUMBER: 198019864
	VISIT DATE: 09/12/2022

NARRATIVE

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Smoke and carbon monoxide detectors were tested and are operable. The 2A10BC fire extinguisher was last serviced on 06/22/2022. The home maintains telephone service via landline and cell phone. There are toys and other age appropriate material available for children. LPA observed that detergents, cleaning compounds and medication are kept in hallway cabinets and was inaccessible to children. Licensee states that there are no poisons stored in the home and understands that all poisons must be lock, not only inaccessible to children. Isolation area for sick children waiting to be picked up near the front door, away from the other children. Per Licensee there are no firearms or weapons stored in the home.

During tour at 9:40- LPA observed the children's restroom not flushed. Licensee flushed toilet and cleaned restroom. A technical violation was given.

Infant Care: Currently licensee has four infants enroll. LPA did not observed any playpens or cribs. Per Licensee infants are all over the age of 1 and sleep on mats. LPA reviewed the following is case Licensee has infants in the future: napping equipment can not block entrances or exits. Infant mattresses were need to be firm with tightly fitted sheets. Playpens or cribs can not have any loose object, bumpers, objects hanging, or objects attached. LPA informed licensee of the new Safe sleep regulations, including LIC 9227 Infant Sleep Plan for infants under 12 months, 15-minute sleep check documentation for infants 0-24 months, and provided PIN 20-24-CCP. Licensee documents 15 minute sleep log on a app called Bright Wheel.

Currently, children are using the back yard for outdoor play. The outdoor play area was observed to be fenced. LPA's observed that the outdoor yard has toys and other materials for children to play with. LPA's did not observe any objects that could be hazardous to children in care. Per Licensee there are no bodies of water on the premises.

During inspection all children were observed to be treated with dignity and respect, they were observed to be receiving safe, healthful and comfortable accommodations, furnishings and equipment, and free from corporal and/or unusual punishment.

Children’s records were reviewed for (LIC) 282- Affidavit Regarding Liability Insurance, Immunizations Records, LIC 700- Identification and Emergency Information, LIC 627- Consent for Medical Treatment, LIC 995A Notification of Parents’ Rights, LIC 9227- Infant sleep form was given during inspection and the sleep log (0-12 months)

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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: WILLIAMS-GREER FAMILY CHILD CARE	FACILITY NUMBER: 198019864
	VISIT DATE: 09/12/2022

NARRATIVE

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Staff records were reviewed for approved; LIC 508-Criminal Record Statement, LIC 9052- Employee Rights, Proof of immunizations against measles, pertussis and influenza or influenza declination, TB clearance or risk assessment, LIC 9108- Statement of Child and Mandated Reporter Training Certificate.

During staff file review, Pediatric First Aid and CPR certification, had expired on 08/01/2022.

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 Center and the ADA, available at: http://www.ada.gov/childqanda.htm

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.

Licensee 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.

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.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

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: WILLIAMS-GREER FAMILY CHILD CARE	FACILITY NUMBER: 198019864
	VISIT DATE: 09/12/2022

NARRATIVE

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Per Licensee there are no pets in the home.

Based on the LPA’s observations and records review, the following deficiencies listed on the attached LIC 809 (deficiency page) are being cited in accordance with California Code of Regulations Title 22.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were given and explained. Exit interview conducted and report was reviewed with the Licensee, Kolisha Williams- Greer.

SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Susann Sanchez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2022

LIC809 (FAS) - (06/04)

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