198400052-4-5-2023-54-CC-RDEO-CQLQCJ-20230405120314

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 198400052
Report Date: 04/05/2023
Date Signed: 04/05/2023 12:03:22 PM

Document Has Been Signed on 04/05/2023 12:03 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 S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME:	LACKEY FAMILY CHILD CARE		FACILITY NUMBER:	198400052
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	04/05/2023
TYPE OF VISIT:	Case Management - Other	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Licensee - Tameika Lackey		TIME COMPLETED:	12:20 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) Randy Derraco conducted an unannounced case management inspection to the above mentioned address on 04/05/23 at 9:15 AM. LPA met with licensee, Tamieka Lackey, who guided LPA on a tour of the home. The purpose of this visit is to inspect the home for a capacity increase. LPA observed one adult and four children present during inspection. Individuals residing in the home have been noted and discussed. The applicant is requesting a capacity increase to her family childcare home license. Per licensee, operation hours will be Monday through Friday from 6:00AM to 6:00PM. Licensee states that they will care for children 0 to 13 years old. 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 2 bedrooms, 1 bathroom, Living Room, Dining Room, Kitchen, Detached Garage, Front yard and backyard (fenced). The off limit areas included Bedroom 1, Detached Garage, and Front Yard. Per licensee, the backyard is currently off-limits due to the recent rain storms. Licensee states she plans to have children use the backyard once capacity increase is granted Main care area is located in the living room. LPA observed child sized tables, child sized chairs, a wall mounted television, age appropriate toys, children's reading materials, 3 Graco feeding tables, and educational posters. Per licensee, bedroom 2 will now be used for day care children. LPA observed additional age appropriate toys, rubber mats on the floor and a portable air conditioning unit. LPA observed sleeping cots stored in the closet of bedroom 2. The portable air conditioning unit was observed next to the bedroom window and is made accessible to children. LPA advised licensee that prior to using bedroom 2 for day care children, the air conditioning unit will need to be made inaccessible. The bathroom was observed with an operable sink, toilet, and faucet. A wall heater was observed in the hallway. A service tag was observed attached to the wall heater indicating that it is turned off and requires service prior to use. A black nylon cover was observed to cover the wall heater and is anchored into the wall by push pins. The dining area was observed with a dining table, stools, child sized tables with child sized chairs, and a portable (page 1 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LACKEY FAMILY CHILD CARE	FACILITY NUMBER: 198400052
	VISIT DATE: 04/05/2023

NARRATIVE

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air conditioning unit positioned next to the dining room window. The kitchen was observed to have a child
U-Lock beneath the kitchen sink. LPA observed cleaning supplies stored beneath the kitchen sink. Sharp and pointy objects, such as knives, were observed stored in a cabinet above the the refrigerator. The backyard play area was observed with perimeter fencing and a shaded area. LPA observed a swing set, age appropriate toys and outdoor play equipment in the backyard play area. LPA also observed several fold away chairs, bags of charcoal, wood planks, and dog feces in the backyard play area. A storage shed located in the backyard was observed on top of a cement foundation. LPA observed several metal studs at the edge of cement foundation. A brick was observed to cover a plastic pipe in the back yard. Two uncovered barbeque pits were observed behind the storage shed.

LPA observed the home to have operable telephone service. Heating and air conditioning are provided by portable electrical units. The licensee understands that poisons must be locked away, not just inaccessible to children in care. Parent board is visible in the main care area with required postings. Children will nap on cots in the main care area.

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.

Per licensee, she owns one pet dog and it is kept in the off-limit bedroom during operation hours. There are no firearms or weapons stored in the home and there are no bodies of water. LPA observed that the licensee has a 2A10 BC fire extinguisher in the home, with a service tag dated 10/24/22. Smoke and carbon monoxide detector were tested and are operable. The applicant states that they will provide food for children in care. Any food brought from the children’s homes shall be labeled with child’s name and properly stored or refrigerated.

The applicant has completed the required Health and Safety Training, Nutrition, and Lead Training, Mandated Reporter Training and Pediatric First Aid and CPR. Applicant has proof of required immunization's. Assistants have required training's and immunization's. There are first aid supplies available. (page 2 of 3)

SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

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
MONTEREY PARK S WEST, 1000 CORPORATE CENTER DR 200B
MONTEREY PARK, CA 91754

FACILITY NAME: LACKEY FAMILY CHILD CARE	FACILITY NUMBER: 198400052
	VISIT DATE: 04/05/2023

NARRATIVE

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Incidental Medical Services (IMS):
This facility may provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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 how to access forms, regulations and quarterly updates on the Child Care Licensing website at: www.cdss.ca.gov

Licensee is requesting a large family child care. Fire clearance was approved on 01/19/23. A large family childcare license may be granted upon Licensing Program Manager (LPM) Approval. Once licensed, the Licensee is required to comply with the terms and limitations stated on the license.

Prior to approval for a large family child care license, the following corrections must be observed:

-An updated facility sketch indicating all off-limit areas must be provided

-AC unit located in bedroom 2 and in the dining room must be made inaccessible.
-Age appropriate locks must be used beneath the kitchen sink
-Wooden planks must be removed from backyard play area
-Dog feces must be cleaned up in the backyard play area. Licensee must provide a cleaning plan showing how she plans to clean backyard of dog feces prior to use by children in care.
-Metal studs must be made inaccessible in the backyard play area.
-Barbeque pits and charcoal must be made inaccessible in the back yard play area
-Fold away chairs must be made inaccessible in the backyard play area
-Loose objects such as bricks and storage containers must be secured or made inaccessible in the backyard.

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 Tameika Lackey.

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SUPERVISORS NAME: Karen Chambers
LICENSING EVALUATOR NAME: Randy Derraco
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2023

LIC809 (FAS) - (06/04)

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