198400006-7-10-2024-54-CC-FWHE-D72T2Y-20240710142132

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400006
Report Date: 07/10/2024
Date Signed: 07/10/2024 02:21:46 PM

Document Has Been Signed on 07/10/2024 02:21 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:	GREEN FAMILY CHILD CARE		FACILITY NUMBER:	198400006
ADMINISTRATOR/ DIRECTOR:	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:	07/10/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	12:15 PM
MET WITH:	Jenae Green, Licensee		TIME VISIT/ INSPECTION COMPLETED:	02:45 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 (LPAs) F. White and K. Dunlap arrived at the above facility for the purpose of an unannounced annual inspection. LPA White announced the purpose of the visit and was granted entry into the facility by Licensee Jenae Green. There are 17 enrolled children, and 14 children present at the time of inspection. This facility served children ages two months to twelve years of age. All staff and residence over 18 discussed and have current background clearance. The Parent Board was observed to have all department required documentation. The facility roster was available during the inspection, and the most recent disaster drill was conducted 6/12/2024. This is a single story home with three bedrooms, two bathrooms, living room, kitchen, and backyard. Main care areas for children and parents are bedroom 3, and driveway (temporary play area during backyard construction). Ares off limits according to the facility sketch provided to the department are living room, kitchen, bathroom 1 and bedrooms 1 and 2. All areas of the home were inspected for health, safety, heating and ventilation of the children in care. The following life saving devices were inspected for the safety of the children in care: fire extinguisher: Service tag - 5/20/2022 Carbon monoxide detector - operable Smoke Detector - operable The entrance to the facility is through the gate leading to the driveway. The gate is locked during hours of operation. There is a Ring doorbell for Licensee to communicate before opening gate. Upon entry of the side of the outside of the home is a temporary play area due to the construction work of the backyard. Entry into the facility is through a side door that takes you in the the main care area. ..............................................................Report Continues 1 of 4 Pages..................................................

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

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 5

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: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 198400006
	VISIT DATE: 07/10/2024

NARRATIVE

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At the opening of the door are cubbies for each of the children in care. The door to the right leads to the main care area. The entrance to the left is to the off limits kitchen area of the home that is made inaccessible to children and parents by the use of a baby gate.

At 12:20 LPA White observed the Main care area to be spacious with plenty of seating and tables for the children separated as activity spaces. The multi-colored rugs for seating on the floor have alphabets and animals with activity storage cabinets along the walls filled with activities, games, and puzzles. There are learning posters lining the walls throughout the main care area. There are black drawers labeled with the names of each child for sleeping items. There is a changing area near bathroom #2 stocked with baby wipes, and a diaper genie. There are double doors leading to the "temporarily" off limits back yard that is made off limits to the children by the use of child safety locks. LPA White observed bookshelves located under the large mounted flat screen tv to have toy cars, storage cases of legos, manipulatives, and soft blocks. Licensee states that napping cots are located in the shed located outside the main care area space under a shading tarp.

At 12:25 p.m., Bathroom #2 was inspected for cleanliness, and sanitation. LPA did not observe any flooring hazards, sharp objects, cleaning solutions in the bathroom. Bathroom was stocked with toilet paper, hand washing soap, and paper towels for the children.

At 12:30 p.m., the kitchen was observed to be made off limits by the use of a baby gate. According to the licensee all cleaning supplies are located in the cabinet in the kitchen. LPA White reminded Licensee that poisons and cleaning supplies have to be locked and made in accessible to children in care.

At 12:45 p.m., LPA Dunlap reviewed the staff files of the facility. Licensee and Staff Assistant immunization records were available during todays inspection. Licensee's file was observed to have a CPR/First Aid certificate from a facility not approved by the department. This poses a potential risk to the health and safety of the children. A current Mandated Reporter Training certificate with a date of 5/9/2024 was observed in the file.

.........................................................Report Continues 2 of 4 Pages..........................................................

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 198400006
	VISIT DATE: 07/10/2024

NARRATIVE

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At 12:50 p.m., LPA Dunlap reviewed the children's files. All children's files had the required facility documentation required by the department.

The following were discussed with Licensee:
Applicant Jenae Green was reminded that all adults 18 and over living in the home, persons who provide care and supervision to children, and staff who have contact with children, 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.

The Jenae Green, Licensee provided proof of control of property.

LPA reviewed with Jenae Green the LIC 311D, Forms/Records to Keep In Your Family Child Care Homes, children’s forms/records, facility forms/records, and information to be posted. Entrance Checklist was provided to the applicant. PIN 22-05-CCP Page Eight

LPA discussed the safe sleep regulations with Jenae Green] 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 [applicant, licensee, or 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.

......................................Report Continues 3 of 4 Pages...........................................................................

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 07/10/2024 02:21 PM - It Cannot Be Edited

Created By: Franchesca White On 07/10/2024 at 01:33 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 CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 198400006
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/10/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102417(g)(1)

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: (1) Fireplaces and open face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshall. 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 infacility did not have a fire extinguisher with current service tag which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/12/2024
	Plan of Correction
1 2 3 4	Licensee states that she will provide proof od service or purchase of fire extinguisher on or before the POC date by email or text.

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 record review the licensee did not comply with the section cited above in licensee and assistant did not have approved CPR / First Aid certificates which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/12/2024
	Plan of Correction
1 2 3 4	Licensee states that she will provide proof of completion of the approved CRP / First Aid training on or before the POC date by email or text.

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:

Denise Gibbs

LICENSING EVALUATOR NAME:

Franchesca White

LICENSING EVALUATOR SIGNATURE:

DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

LIC809 (FAS) - (06/04)

Page: 2 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 SW RO, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: GREEN FAMILY CHILD CARE	FACILITY NUMBER: 198400006
	VISIT DATE: 07/10/2024

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On this date, 7/10//2024, the California Attorney General - Megan’s Law website was searched for information on sex offenders required to register with local law enforcement under California's Megan's Law. No registered sex offenders were found at the facility addresses. Under state law, some registered sex offenders are not subject to public disclosure; therefore, they may not have been included in this search. However, the Department conducts a monthly cross reference of each address on record for all registered sex offenders against all CCLD facility addresses pursuant to information shared by California DOJ.

Jenae Green was informed of the MyChildCarePlan.org site, 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.

The following deficiencies listed on the LIC 809D needs be cleared for the health and safety of the children.

A notice of site visit was given to Jenae Green and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

The report was reviewed with the Jenae Green. A Copy of the report and appeal rights was given to Licensee Jenae Green.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms.

To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

...............................................Report Ends 4 of 4 Pages.........................................................................

SUPERVISORS NAME: Denise Gibbs
LICENSING EVALUATOR NAME: Franchesca White
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2024

LIC809 (FAS) - (06/04)

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