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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198019959
Report Date: 06/11/2024
Date Signed: 06/11/2024 03:49:11 PM

Document Has Been Signed on 06/11/2024 03:49 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:MACK FAMILY CHILD CAREFACILITY NUMBER:
198019959
ADMINISTRATOR/
DIRECTOR:		MYESHA MACKFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(323) 812-3674
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY: 14TOTAL ENROLLED CHILDREN: 12CENSUS: 8DATE:
06/11/2024
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:00 PM
MET WITH:MYESHA MACK / LICENSEETIME VISIT/
INSPECTION COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced annual inspection at the above facility. LPA met with Assistant Staff Leila Mack who granted LPA entry, Licensee Myesha Mack arrived upon LPA gaining entry to home. There were 8 children present during today's inspection. Facility capacity is in compliance for a Large Family Child Care Home. Hours of operation are Mon-Fri 7:00 AM - 6:00PM.

This is a two-story home which consists of 4 bedrooms, 3 bathrooms, kitchen, dining room (multipurpose child care room), living room (day care room), front yard, and backyard (fenced). Staircase has a baby gate to prevent children from access to upstairs of the home. Per licensee, areas off limits to children and parents include: 4 bedrooms upstairs and 2 restroom upstairs. The children and use: the multipurpose dining room, 1 downstairs bathroom, backyard (fenced), and day care/ living room. Garage access from the dining room kept locked and inaccessible to children in care.

Individuals residing in the home have been discussed and noted. 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 3/1/24. Smoke and carbon monoxide detectors devices which were tested and are operable. Fire extinguisher indicated fully charged and services, Per Licensee purchases extinguisher yearly and keeps receipts, LPA observed receipt. The home maintains telephone service via cell phone and landline line. The home is observed to be clean and orderly. There are toys and other age appropriate material available for children inside and outside of the home.

(Page 1, Continuation Lic809-C...)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE: DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/11/2024
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 2
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: MACK FAMILY CHILD CARE
FACILITY NUMBER: 198019959
VISIT DATE: 06/11/2024
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LPA observed that detergents, cleaning compounds, sharps inaccessible to children. Licensee understands that all poisons must be locked, per licensee no poisons stored in the home. Per Licensee there are no firearms or weapons stored in the home. Per Licensee, no children on medication. Per Licensee, provides children with food. LPA advised licensee foods brought from children home should be labeled and sealed and stored correctly.Per Licensee does not provide any overnight care at this time and currently has no infants in care. Per Licensee, no pets remain in the home.

Currently, children are using the backyard for outdoor play. LPA observed children playing in the back yard, only half of the backyard is accessible to children. The outdoor play area was observed to be fenced. LPA observed that the outdoor yard has toys and other materials for children to play with. LPA observed half of backyard inaccessible to children in care fenced off with a fence which maintains storage large items and toys that are unused , and toys that are used to rotate toys for children to play with. There are no pools or spas, or other bodies of water, Licensee was advised if any plans to have bodies of water to call licensing before changes.

LPA will return at a further time to complete staff interview , Care Tool and staff and children record review.

Based on today’s visit, Per California Code of Regulations Title 22, the facility was found to be incompliance.

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

Exit interview conducted and report was reviewed with the licensee and was provided to Assistant Staff Leila Mack to provide to Licensee Myesha Mack

(Page 2, End of Report)
SUPERVISORS NAME: Valarie Cook
LICENSING EVALUATOR NAME: Ashley Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2024
LIC809 (FAS) - (06/04)
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