198021081-10-18-2024-33-CC-SLII-DA4R2V-20241016123859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198021081
Report Date: 10/16/2024
Date Signed: 10/18/2024 09:26:32 AM

Document Has Been Signed on 10/18/2024 09:26 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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME:	FAWAZ FAMILY CHILD CARE		FACILITY NUMBER:	198021081
ADMINISTRATOR/ DIRECTOR:	FAWAZ, HELEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(818) 568-4400
CITY:	POMONA	STATE: CA	ZIP CODE:	91767
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 10	CENSUS: 6	DATE:	10/16/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	10:41 AM
MET WITH:	Licensee Helen Fawaz		TIME VISIT/ INSPECTION COMPLETED:	01:00 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	On 10/16/24 at 10:15am, Licensing Program Analyst (LPA) Stephanie Li conducted an unannounced required annual inspection to the above facility. A risk assessment was conducted upon entry. LPA met with Licensee Helen Fawaz, who guided analyst on a tour of the facility. There was 6 children and 2 adults present during visit. Per Licensee, there is currently 10 children enrolled. A current children’s roster was available for review. This is a two story home which consists of 6 bedrooms, 3 restrooms, living room, dining/kitchen, play room, front yard garage, and back yard (fenced). The children have access to living room, kitchen, playroom, 1 bathroom, and front yard. The licensee states that 4 adults and 3 children currently live in the home. Per Licensee, there are no firearms or weapons stored in the home. Home does have a fenced pool in the off limits back yard. Per licensee, areas off limits to children and parents include all 6 bedrooms, 2 restrooms, kitchen, back yard and garage. LPA toured all areas used by children during this visit. Rooms that are off-limits need to be made inaccessible during operating hours The Licensee does understand that licensing staff may have access to off-limit areas during inspection visit if necessary.** 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 observed cleaning compounds and poisons are NOT accessible to children. Medications were observed to be inaccessible to children. The restroom that children use was observed to be sanitary. There is telephone service via cellphone that stays at the facility during operation hours. The home is observed to be clean and orderly with central ac and heat. There are toys available for children. Per licensee, the children nap in the play room on cots stored in the closet. Page 1 of 4

SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FAWAZ FAMILY CHILD CARE	FACILITY NUMBER: 198021081
	VISIT DATE: 10/16/2024

NARRATIVE

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At 11:00am, LPA observed the required 2A 10BC fire extinguisher, purchase receipt indicates purchased on 10/1/2024. Smoke and carbon monoxide detectors were tested and are operable. All homes shall conduct fire and disaster drills at least once every six months, and document the date and time of each drill. Last drill was conducted on 5/13/2024. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted on the parent board in the play room.

Currently, children are using the front yard for outdoor play time. The outdoor play area was observed to be fenced adequately. LPA observed the outdoor yard to have appropriate toys and other materials for children to use. LPA did observe a fenced pool in the back yard. LPA checked the gate and self latching. Pool gate DOES NOT self latch. Per Title 22, pool gates shall swing close and self latch. A deficiency is being cited on 809D page. LPA did not observe any objects that can pose a danger to children in the outdoor yard. LPA did observe the gates along the side of the house restricting access to the back yard was not securely installed. LPA witnessed Licensee fix the gates and verified that the gates were securely installed. The licensee is observed to be operating within the license capacity limitations.

At 11:45 am, children and adult records were reviewed. The licensee has completed training on preventive health practices including Pediatric First Aid and CPR. The licensee Pediatric First Aid and CPR expired on 8/26/2026 . There are first aid supplies available. Licensee and assistant has completed the Mandated Reporter AB 1207 Training, exp 12/9/25. Licensee was reminded that Mandated Reporter Training must be completed every two years.

Children records were available for review. Children's file review was noted on LIC857.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FAWAZ FAMILY CHILD CARE	FACILITY NUMBER: 198021081
	VISIT DATE: 10/16/2024

NARRATIVE

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Licensee stated no IMS is being provided at this time. 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/.

LPA’s discussed the safe sleep regulations and discussed the Child Care Licensing Safe Sleep webpage at http://www.cdss.ca.gov/inforescources/child-care-licensing/public-information-and-resoucrces/safe-sleep as an additional resource. LPA also informed applicant/licensee of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at http://www/cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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.

Megan’s Law - Family Child Care Homes During the exit interview, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

LPA’s advised the licensee to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.ccld.ca.gov

MyChildCarePlan.org – Centers and Family Child Care Homes 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

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK CC RO, 1000 CORPORATE CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FAWAZ FAMILY CHILD CARE	FACILITY NUMBER: 198021081
	VISIT DATE: 10/16/2024

NARRATIVE

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Currently, based on Licensing staff observations, the following deficiencies listed on the attached LIC 809D (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 and safety.

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

Exit interview conducted and appeal rights was reviewed with Licensee Helen Fawaz.

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SUPERVISORS NAME: Christina Gabelman
LICENSING EVALUATOR NAME: Stephanie Li
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

Document Has Been Signed on 10/18/2024 09:26 AM - It Cannot Be Edited

Created By: Stephanie Li On 10/16/2024 at 12:00 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 CNTR DR. 200-B
MONTEREY PARK, CA 91754

FACILITY NAME: FAWAZ FAMILY CHILD CARE	FACILITY NUMBER: 198021081
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(5)(A)

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: (5) All licensees shall ensure the inaccessibility of pools (in-ground and above-ground), fixed-in-place wading pools, hot tubs, spas, fish ponds and similar bodies of water through a pool cover or by surrounding the pool with a fence. (A)Fences shall be at least five feet high and shall be constructed so that the fence does not obscure the pool from view. The bottom and sides of the fence shall comply with Division 1, Appendix Chapter 4 of the 1994 Uniform Building Code. In addition to meeting all of the aforementioned requirements for fences, gates shall swing away from the pool, self-close and have a self-latching device located no more than six inches from the top of the gate. Pool covers shall be strong enough to completely support the weight of an adult and shall be placed on the pool and locked while the pool is not in use. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation, the licensee did not comply with the section cited above in the pool gate does not self latch when swinging close, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 11/06/2024
	Plan of Correction
1 2 3 4	Per licensee, she will order a new gate door or spring and have her handyman install it. Licensee will send LPA a video of pool gate swing and self latch before 11/06/2024.

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:

Christina Gabelman

LICENSING EVALUATOR NAME:

Stephanie Li

LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC809 (FAS) - (06/04)

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