198400006-8-9-2022-54-CC-RDEO-CH5QSU-20220809122608

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400006
Report Date: 08/09/2022
Date Signed: 08/09/2022 12:26:16 PM

Document Has Been Signed on 08/09/2022 12:26 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	GREEN FAMILY CHILD CARE		FACILITY NUMBER:	198400006
ADMINISTRATOR:	JENAE GREEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(562) 713-1163
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 14	DATE:	08/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Licensee - Janea Green		TIME COMPLETED:	12:40 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 required one year inspection to the above facility on 08/09/22. LPA arrived at the facility at 9:45AM and met with licensee, Janae Green, who guided analyst on a tour of the facility. Also present during this inspection was an assistant S2. Per licensee, there are 14 children that are currently enrolled. There were 14 children present upon arrival. This is a one-story home which consists of 3 bedrooms, 2 bathrooms, kitchen/dining room, living room, a detached garage, front yard and backyard (fenced). The off limit areas include 2 bedrooms, 1 bathroom, kitchen/dining room, living room, detached garage, and front yard. The main care are is located in bedroom 1. LPA observed child sized chairs, child sized tables, age appropriate toys, 2 Cosco playpens, a baby changing station, art materials and a wall mounted television. The bathroom designated for children in care was observed to be clean and free of defects. A baby gate was observed to separate the main care area from the off limits kitchen/dining area. The outdoor play area is located in the backyard and observed to have perimeter fencing. Outdoor play equipment such as tricycles and wagons were observed. A wooden swing set with a plastic slide was also observed in the backyard play area and is free of any pointy or loose parts. LPA observed that shade is provided by an awning. Two storage sheds were observed to be locked in the backyard play area. The licensee states that she provides food for children in care. Per licensee, isolation area for children showing signs of illness will be located between the off-limits kitchen and main care area. LPA did not observe the following items during the inspection: Infant Walkers, Johnny Jumpers, Saucer Chairs. No bodies of water were observed in the back yard play area. Emergency Disaster Plan, Parent’s Rights Poster and the Facility License were observed to be posted. Individuals who reside in the home were noted and discussed. Licensee was reminded that all adults 18 and (page 1 of 3)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

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 3

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: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 198400006
	VISIT DATE: 08/09/2022

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
26
27
28
29
30
31
32

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. Licensee states that there are no firearms stored in the home.

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 landline. Per Licensee, the home is equipped with central heating and air conditioning. Day care area was observed with safe toys, play equipment and materials.

Detergents, cleaning compounds, and other items which could pose a danger to children were observed to be locked in a cabinet located in the kitchen. The licensee states that there are no poisons in the home and understands that storage areas for poisons must be locked, not just inaccessible. The valve on the required 2A-10BC fire extinguisher indicates fully charged and was serviced on 05/20/22, as indicated on service tag. Smoke and carbon monoxide detectors were tested and are operable. Smoking is prohibited in a licensed Family Child Care Home. Per Licensee, no one smokes in the home.

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.

The licensee and other personnel have completed training on preventive health practices including Pediatric First Aid and CPR. The licensee's Pediatric First Aid and CPR expires on 05/26/24. LPA observed that the Licensee and assistant do have 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, including emergency information and were observed to be complete. A current children’s roster was available for review.

(page 2 of 3)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 198400006
	VISIT DATE: 08/09/2022

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
26
27
28
29
30
31
32

Incidental Medical Services (IMS):
IMS was discussed with licensee. Per licensee, there are no children enrolled that require IMS at this time. 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.

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

At this time, the licensee is in compliance with California Code of Regulations Title 22. No deficiencies cited.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the licensee Janae Green.

(page 3 of 3)

SUPERVISORS NAME: Trevino Cochran
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

LIC809 (FAS) - (06/04)

Page: 3 of 3