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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198020948
Report Date: 01/06/2022
Date Signed: 01/06/2022 01:55:14 PM

Document Has Been Signed on 01/06/2022 01:55 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:THORNBER FAMILY CHILD CAREFACILITY NUMBER:
198020948
ADMINISTRATOR:THORNBER, ANTONIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 254-5422
CITY:LOS ANGELESSTATE: CAZIP CODE:
90028
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 0DATE:
01/06/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
09:29 AM
MET WITH:Antonia Thornber - ApplicantTIME COMPLETED:
12:00 PM
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On 1/6/22 at 9:29 AM Licensing Program Analyst (LPA) Steven Tung and LPA Mireya Garcia conducted a pre-licensing inspection to inspect and evaluate facility for a Family Child Care Home relocation. Applicant is relocating Thornber Family Child Care Home (#198019858) from 1923 N. Wilton Pl, Los Angeles, CA, to this new location. A risk assessment was conducted upon entry- appropriate PPE was used. LPA met with Antonia Thornber, applicant who guided licensing staff on a tour of the facility. Per applicant, there are no other adults or children residing at the home. Per applicant, operation hours will be Monday to Friday, 8:30AM to 3:00PM. Applicant states that she will care for children 2-5 years of age.

All areas identified on the facility sketch were inspected, including but not limited to, off limit areas. This is a one story home that consists of 1 living room and 1 dining room (daycare space), 2 bathrooms (Bathroom #1, Bathroom #2), kitchen, laundry room, basement, 3 bedrooms (Room #1, Room #2, Room #3), front and back yard (which is fenced and connected by a driveway on the side of the house). The applicant will reside in the converted detached garage in the back yard (which has a bathroom and kitchen), but LPAs did not observe any personal belongings in the garage.

Per applicant, the children will use 2 restrooms, the 3 bedrooms, living room, dining room, and backyard. Areas that will be used by children were inspected for safety, comfort, cleanliness, telephone service, ventilation and heating. Home has central air and heat. Detergents, cleaning compounds, medicines, sharp objects and hazardous items that can pose a danger to children are inaccessible in areas designated for children. The applicant states that there are no poisons on the premises. Applicant was advised that any poisons must be locked with a key or combination lock.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE: DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/06/2022
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: THORNBER FAMILY CHILD CARE
FACILITY NUMBER: 198020948
VISIT DATE: 01/06/2022
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LPAs observed a fireplace in the living room (daycare space) which is made inaccessible for children in care.

Based on the Facility Sketch submitted, areas off-limits to children and parents are: front porch, driveway, small alley to the right of the facility, and the converted detached garage. The inaccessible areas to children have a locking fence or locking door making it inaccessible. The applicant understands that licensing staff may have access to off-limit areas during inspection visit if necessary.

OUTDOOR PLAY AREA


The children will use the back yard for outdoor play and was observed to be fenced. Licensing staff observed that the off limits is inaccessible by a locked white fenced. The small space between the garage and the fence separating properties has not been made inaccessible to children. The back yard was observed with toys and equipment for children to play with. LPAs observed a bunny hutch in the back yard that will house bunnies.

Per applicant, there are no firearms, weapons or bodies of water on the premises. LPAs did not observe any bodies of water.

The valve on the 2A10BC fire extinguisher indicates fully charged and was last serviced on 12/15/21 as indicated on the service tag. Smoke and carbon monoxide detectors were tested and are operable.

The applicant states that the children will bring their own meals, but the applicant will provide snacks.

The applicant has completed the required Health and Safety Training, Nutrition Training and Pediatric First Aid and CPR. There are first aid supplies available.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: THORNBER FAMILY CHILD CARE
FACILITY NUMBER: 198020948
VISIT DATE: 01/06/2022
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At 11:15 AM the following was discussed with the applicant:
 Individuals who are 18 years of age or older living in the home must obtain a criminal record clearance. Individuals within one month of their 18th birthday must be fingerprinted immediately. Civil Penalties will be assessed if not in compliance.
 In the absence of the licensee a qualified adult must be present supervising the children; a qualified adult is an individual who has a valid and current Pediatric First Aid and CPR training, Immunizations (TDAP, MMR, Influenza), mandated reporter training and a valid criminal record clearance associated to the facility license.
 Annual fees must be paid promptly and by the due date or a late fee shall be assessed and/or the License may be terminated.
 The fire extinguisher type 2A10BC must be serviced annually or as often as necessary. Smoke and carbon monoxide detectors should be checked and batteries replaced as needed.
 Reporting Requirements: Changes should be reported to the Department as soon as they occur such as construction, remodeling, telephone number changes and/or if you move from your home.
 Reporting Requirements: Any unusual incidents or injuries must be reported to the Department within 24 hours via telephone and within seven (7) days in writing.
 Fire and safety drills must be performed every six months and documented for review by the Department.
 Smoking is prohibited in a family child care home.
 Children and Staff records must be maintained and updated as needed and must be available for review by the Department.
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.
Immunization Requirement: H&S 1597.622: Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. The licensee and all adults working with children have proof of immunizations.
Mandated Reporter Training: H&S 1596.8662: Beginning January 1, 2018, all licensed providers, applicants, directors and employees to complete training as specified on mandated reporter duties. Training is available at: www.mandatedreporterca.com
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: THORNBER FAMILY CHILD CARE
FACILITY NUMBER: 198020948
VISIT DATE: 01/06/2022
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Infant Care: Applicant states that they will not care for infants. LPA discussed the safe sleep regulations with licensee [or facility representative] 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 [facility representative] 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):
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

LPAs advised the applicant how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov.

All required forms listed were explained and provided to the applicant during this visit.

The applicant’s signature on this report acknowledges that they have signed the Application for a Family Child Care Home License (LIC 279) under the penalty of perjury that the statements on the application and any attachments are correct.

SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
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 CNTR DR. 200-B
MONTEREY PARK, CA 91754
FACILITY NAME: THORNBER FAMILY CHILD CARE
FACILITY NUMBER: 198020948
VISIT DATE: 01/06/2022
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Based on licensing staff observations, the following corrections need to be corrected prior to obtaining a large family child care license. Corrections are due 2/04/22.

 Applicant states that she will make the small areas between the garage and the fencing separating properties inaccessible.
 Applicant states that she will add all the COVID posting in the home.
 Applicant will obtain permission from neighbors to evacuate children to their properties for emergency evacuation and update Emergency Evacuation Plan.
 Applicant will update facility sketch with basement sketch, laundry room, new room names and converted detached garage.
 Applicant will make sure all outlets are covered.
 Applicant will make cabinets below kitchen sink inaccessible.
 Applicant states that she will bring personal belongings to the converted detached garage.


Once corrections are made the application will be submitted for final review to the department. Once licensed, the applicant is required to adhere to the terms and limitations stated on the license.

Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty.

At 11:53AM Exit interview conducted and report was reviewed with the applicant Antonia Thornber.
SUPERVISORS NAME: Brandi VanOosten
LICENSING EVALUATOR NAME: Steven Tung
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
LIC809 (FAS) - (06/04)
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